CN103347452A - Insertion instrument for anchor assembley - Google Patents

Abstract

An insertion instrument is configured to eject at least one anchor body into respective target locations, and subsequently apply a predetermined tensile force at least one actuation member of the at least one anchor member so as to actuate the at least one anchor body from a first configuration to a second expanded configuration. The insertion instrument can include a tension assembly that applies the predetermined tensile force to the at least one actuation member. The predetermined tensile force can be defined by a distance of travel, a predetermined failure force of a fuse, or a combination of distance of travel and a predetermined failure force of a fuse.

Description

The insertion apparatus that is used for the anchor log assembly

CROSS-REFERENCE TO RELATED PATENT

Present patent application is the U.S. Patent Application Serial Number of submitting on June 29th, 2,011 13/172,619 part continuation application, described U.S. Patent Application Serial Number 13/172,619 is the part continuation application of the U.S. Patent Application Serial Number 13/095,192 of submission on April 27th, 2011.U.S. Patent Application Serial Number 13,172,619 U.S. Patent Application Serial Number 61/398 that also require people such as Overes to submit on June 29th, 2010,699, the U.S. Patent Application Serial Number 61/432 submitted on January 14th, 2011 of people such as Henrichsen, 755, the U.S. Patent Application Serial Number 61/461 submitted on January 18th, 2011 of people such as Henrichsen, 490, and Overes is in the rights and interests of the U.S. Patent Application Serial Number 61/443,142 of submission on February 15th, 2011.U.S. Patent Application Serial Number 13/095,192 U.S. Patent Application Serial Number 61/328 that require Overes to submit on April 27th, 2010,251, the U.S. Patent Application Serial Number 61/398 that people such as Overes submitted on June 29th, 2010,699, the U.S. Patent Application Serial Number 61/432 that people such as Henrichsen submitted on January 14th, 2011,755, the U.S. Patent Application Serial Number 61/461 that people such as Henrichsen submitted on January 18th, 2011,490, and Overes is in the rights and interests of the U.S. Patent Application Serial Number 61/443,142 of submission on February 15th, 2011.The disclosure of above-mentioned every piece of patent application is all incorporated this paper into way of reference shown in its full text.The attorney of submitting on the same day with this paper is that the disclosure that SYNT-3586 and name are called the common unsettled U.S. Patent application of " Method for Approximating a Tissue Defect Using an Anchor Assembly " is incorporated this paper with way of reference as it shown in full accordingly.The attorney of submitting on the same day with this paper is that the disclosure that SYNT-4842 and name are called the common unsettled U.S. Patent application of " Stitch Lock for Attaching Two or More Structures " is incorporated this paper with way of reference as it shown in full accordingly.

Background technology

Plastic surgery operations is usually directed to the use of fixture.Usually formation enters the hole in bone or soft tissue, suitable fixture can be fixed on to enter in the hole.Except screw, can use the fixture that can expand, described fixture inserts in the hole with collapsed state, and in case is properly oriented and just changes swelling state into.

An exemplary plastic surgery operations for example in Wicresoft's lumbar discectomy art, the reconstruction of nucleus gelatinosus tissue of deviating from by surgical resection is realizing nerve decompression, thus the treatment radiculopathy.Wicresoft's lumbar discectomy art is one of modal spinal surgery that adopts now.By this operation, many patients' symptom is eased, but for other patients, intervertebral disc may be deviate from again by the opening in the fibrous ring, thereby causes constant pain, and may need other surgical operation.At present, it is damaged that Wicresoft's discectomy technology of standard does not relate to closed fibrous ring, and the surgeon is got into a difficult position.The surgeon can select to excise invade neural nucleus pulposus deviate from part with the treatment radiculopathy, but this may increase postoperative residue nucleus pulposus by the damaged risk of deviating from again of both depositing of fibrous ring.Perhaps, the surgeon can select to subtract on a large scale long-pending operation, and except the part excision that will deviate from, the major part of also excision residue nucleus pulposus is down to minimum with the risk that postoperative is deviate from again in this operation process.Yet the postoperative disc height is collapsed and the risk that develops into low back pain subsequently can increase.

Conventional expansible implant comprises sleeve pipe and extends through the compressing member of the central bore of sleeve pipe, sleeve pipe has expandable part, described expandable part has a plurality of finger pieces or expansible elements, and described finger piece or expansible elements are formed by the medial slot in the perisporium of sleeve pipe or hole.Compressing member can be attached to the front end of sleeve pipe, makes towards the described compressing member of sleeve pipe rear end tractive the time, and described finger piece or the bending of expansible elements outward radial, thus change described expandable part into its swelling state from its collapsed state.

Summary of the invention

According to an embodiment, insert apparatus and be configured to eject at least one anchor log in target location.Anchor log comprises the anchor log main body of extending along prolonging direction basically, and basically along the actuation member of prolonging direction from the anchor log Subject Extension.Insert the member that enters that apparatus can comprise elongation longitudinally, and the anchor log shell that carries described at least one anchor log releasedly, describedly enter the far-end that component limit is configured to insert at least in part the target location.The anchor log shell is configured to and enters member and align.Insert apparatus and also can comprise pusher member, described pusher member is configured to insert the anchor log shell and from the anchor log shell described at least one anchor log is ejected the far-end that enters member.

Description of drawings

When reading by reference to the accompanying drawings, will understand the following detailed description of foregoing invention content and the application's exemplary embodiment better, show exemplary embodiment for illustrational purpose in the accompanying drawings.Yet should be appreciated that the application is not limited to accurate arrangement and the instrument that illustrates.In the accompanying drawings:

Figure 1A is the schematic side elevation view that comprises the anchor log assembly of a pair of anchor log main body, and described anchor log main body is damaged implanted across dissecting, and is depicted as and is in first configuration;

Figure 1B is the schematic side elevation view of the anchor log assembly shown in Figure 1A, shows to be in expanded configuration and to be in anchor log main body near the position;

Fig. 1 C is the side front view of anchor log assembly, and this anchor log assembly comprises the anchor log main body shown in Figure 1A and the connector members that is configured to the actuation part of attached anchor log main body, shows the anchor log main body that is in first configuration;

Fig. 1 D is the side front view of the anchor log assembly shown in Fig. 1 C, shows the connector members that fixes with the anchor log main body that is in expanded configuration;

Fig. 1 E for Fig. 1 C in the anchor log component class like but comprise the side front view of the anchor log assembly of integral connectors member;

Fig. 1 F is the side front view of the anchor log assembly shown in Fig. 1 E, shows the connector members that fixes with the anchor log main body that is in expanded configuration;

Fig. 1 G is the schematic side elevation view that comprises the anchor log assembly of a pair of anchor log main body, and described anchor log main body is constructed according to alternative embodiment, and it is depicted as across dissecting damaged implanted, and is depicted as and is in first configuration;

Fig. 1 H is the schematic side elevation view of the anchor log assembly shown in Fig. 1 G, shows to be in expanded configuration and to be in anchor log main body near the position;

Fig. 2 A is the side front view that comprises the anchor log assembly of first anchor log and second anchor log, and described first anchor log and second anchor log and are depicted as and are in first configuration on dissecting damaged opposite side in the implanted anatomical structure;

Fig. 2 B is the side front view of the anchor log assembly shown in Fig. 2 A, shows first anchor log and second anchor log that are in corresponding expanded configuration;

Fig. 2 C is the side front view of the anchor log assembly shown in Fig. 2 A, and described anchor log assembly comprises the connector members that first anchor log is attached to second anchor log;

Fig. 3 A is the side front view that comprises at least one anchor log and insert the fixed sleeve part of apparatus;

Fig. 3 B is the sectional side front view of the fixed sleeve part shown in Fig. 3 A;

Fig. 4 A is for constructing, be depicted as the cross section elevational view of the fixed sleeve part that is in first rotation status according to alternative embodiment;

Fig. 4 B is the sectional side front view of the external member shown in Fig. 4 A of 4B-4B along the line intercepting;

Fig. 4 C is the sectional side front view of the fixed sleeve part shown in Fig. 4 A, and still described fixed sleeve part is depicted as and is in second rotation status, thus the alignment pair of holes;

Fig. 4 D is the sectional side front view of the fixed sleeve part shown in Fig. 4 C of 4D-4D along the line intercepting;

Fig. 5 A is the sectional side front view of the insertion apparatus of assembly process;

Fig. 5 B is the sectional side front view of the insertion apparatus shown in Fig. 5 A, and still described insertion apparatus is depicted as and assembles;

Fig. 5 C is the sectional side front view of the shank of the insertion apparatus shown in Fig. 5 B;

Fig. 5 D is the perspective view of the shank shown in Fig. 5 C;

Fig. 6 is the side front view according to the fixed sleeve part of another embodiment structure;

Fig. 7 A is the perspective view that comprises the fixed sleeve part of the insertion apparatus of constructing according to alternative embodiment, described insertion apparatus comprises housing and the intubate of extending from this housing, and be depicted as and be in first configuration, described first configuration has and is loaded into the first anchor log main body and the second anchor log main body of inserting in the apparatus;

Fig. 7 B is the enlarged perspective of the intubate of the insertion apparatus shown in Fig. 7 A;

Fig. 7 C is the sectional side front view of the housing of the insertion apparatus shown in Fig. 7 A;

Fig. 7 D is the sectional side front view of amplification of the intubate of the insertion apparatus shown in Fig. 7 A;

Fig. 8 A is the perspective view of the fixed sleeve part shown in Fig. 7 A, wherein inserts apparatus and is depicted as and is in the second position, in order to eject the second anchor log main body from inserting apparatus, the described second anchor log main body is depicted as and is in first configuration;

Fig. 8 B is the enlarged perspective of the intubate of the insertion apparatus shown in Fig. 8 A;

Fig. 8 C is the sectional side front view of the housing shown in Fig. 8 A;

Fig. 8 D is the sectional side front view of the intubate shown in Fig. 8 A;

Fig. 9 A is the perspective view of the fixed sleeve part shown in Fig. 8 A, shows the insertion apparatus that is in offset position;

Fig. 9 B is the enlarged perspective of the intubate of the insertion apparatus shown in Fig. 9 A;

Fig. 9 C is the sectional side front view of the housing of the insertion apparatus shown in Fig. 9 A;

Fig. 9 D is the sectional side front view of the intubate of the insertion apparatus shown in Fig. 9 A;

Fig. 9 E is the perspective view of the fixed sleeve part shown in Fig. 9 A, shows the second anchor log main body that is in expanded configuration;

Figure 10 A is the perspective view of the fixed sleeve part shown in Fig. 9 A, shows the insertion apparatus that mediates after finishing mid-stroke;

Figure 10 B is the enlarged perspective of the intubate of the insertion apparatus shown in Figure 10 A;

Figure 10 C is the sectional side front view of the housing of the insertion apparatus shown in Figure 10 A;

Figure 10 D is the sectional side front view of the intubate of the insertion apparatus shown in Figure 10 A;

Figure 11 A is the perspective view of the fixed sleeve part shown in Figure 10 A, the insertion apparatus when showing the first that has finished second stroke after mid-stroke;

Figure 11 B is the enlarged perspective of the intubate of the insertion apparatus shown in Figure 11 A;

Figure 11 C is the sectional side front view of the housing of the insertion apparatus shown in Figure 11 A;

Figure 11 D is the sectional side front view of the intubate of the insertion apparatus shown in Figure 11 A;

Figure 12 A is the perspective view of the fixed sleeve part shown in Figure 11 A, show the insertion apparatus that is in the 3rd position behind the second portion of finishing second stroke, just the first anchor log main body is being ejected from the insertion apparatus, the described first anchor log main body is depicted as and is in first configuration;

Figure 12 B is the enlarged perspective of the intubate of the insertion apparatus shown in Figure 12 A;

Figure 12 C is the sectional side front view of the housing of the insertion apparatus shown in Figure 12 A;

Figure 12 D is the sectional side front view of the intubate of the insertion apparatus shown in Figure 12 A;

Figure 12 E is and the perspective view of fixed sleeve part like Figure 12 category-A that still the first anchor log main body is depicted as and is in expanded configuration;

Figure 12 F is after discharging the strand maintaining body, the sectional side front view of the housing of the insertion apparatus shown in Figure 12 A;

Figure 13 A is the perspective view of the insertion apparatus shown in Fig. 7 A, wherein removes the one part in order to guidance system is shown when apparatus is in primary importance;

Figure 13 B is the perspective view of the insertion apparatus shown in Fig. 8 A, shows the guidance system when apparatus is in the second position;

Figure 13 C is the perspective view of the insertion apparatus shown in Fig. 9 A, wherein removes the one part in order to guidance system is shown when the insertion apparatus is in offset position;

Figure 13 D is the perspective view of the insertion apparatus shown in Figure 10 A, wherein removes the one part in order to guidance system is shown when the insertion apparatus mediates;

Figure 13 E is the perspective view of the insertion apparatus shown in Figure 11 A, wherein removes the one part in order to guidance system is shown when the first that the insertion apparatus has been finished second stroke;

Figure 13 F is the perspective view of the insertion apparatus shown in Figure 12 A, wherein removes the one part in order to guidance system is shown when the insertion apparatus has been finished the second portion of second stroke;

Figure 13 G is the perspective view of the guide rail of the guidance system shown in Figure 13 A;

Figure 14 A is the perspective view according to the coupling assembly of an embodiment structure;

Figure 14 B is the sectional side front view of the coupling assembly shown in Figure 14 A, and described coupling assembly is depicted as and is under first operator scheme;

Figure 14 C is the sectional side front view of the coupling assembly shown in Figure 14 B, and described coupling assembly is depicted as the transitive state that is between first operator scheme and second operator scheme;

Figure 14 D is the sectional side front view of the coupling assembly shown in Figure 14 C, and described coupling assembly is depicted as and is under second operator scheme;

Figure 15 A shows the coupling assembly that is arranged under first operator scheme for the sectional side front view of the insertion apparatus of constructing according to another embodiment;

Figure 15 B is the cross section end elevational view of the coupling assembly shown in Figure 15 A of 15B-15B along the line intercepting;

Figure 15 C is the sectional side front view of the insertion apparatus shown in Figure 15 A, but shows the coupling assembly that carries out the transition to second operator scheme from first operator scheme;

Figure 15 D is the cross section end elevational view of the coupling assembly shown in Figure 15 C of 15D-15D along the line intercepting;

Figure 15 E is the sectional side front view of the insertion apparatus shown in Figure 15 C, but shows the coupling assembly that is under second operator scheme;

Figure 16 A is the schematic side elevation view of the anchor log assembly shown in Fig. 1 G, and described anchor log assembly comprises the tensioning strand according to alternative embodiment, and this tensioning strand is illustrated on the anchor log main body of implanting with first configuration;

Figure 16 B is the schematic side elevation view of the anchor log assembly shown in Figure 16 A, but shows the implantation anchor log main body that is in expanded configuration;

Figure 16 C is the schematic side elevation view of the anchor log assembly shown in Figure 16 B, shows another anchor log main body of implanting with first configuration;

Figure 16 D is the schematic side elevation view of the anchor log assembly shown in Figure 16 C, shows another anchor log main body that is in expanded configuration;

Figure 16 E is the schematic side elevation view of the anchor log assembly shown in Figure 16 D, shows the locking of locking component;

Figure 16 F is the schematic side elevation view of the anchor log assembly shown in Figure 16 E, shows the configuration that finally assembles;

Figure 17 A is the perspective view that keeps assembly according to the strand of an embodiment structure, shows releasable locking component;

Figure 17 B is the perspective view that the strand shown in Figure 17 A keeps assembly, shows fixing locking component;

Figure 17 C is the perspective view that the strand shown in Figure 17 A keeps assembly, and described strand keeps assembly operationally to be attached to actuator;

Figure 17 D is the perspective view that the strand shown in Figure 17 C keeps assembly, is depicted as to be in the off-position;

Figure 18 A is the schematic side elevation view of the anchor log assembly shown in Fig. 1 G, and described anchor log assembly comprises a pair of tensioning strand according to alternative embodiment, shows the anchor log main body that is in first configuration;

Figure 18 B is the schematic side elevation view of the anchor log assembly shown in Figure 18 A, but shows the anchor log main body that is in expanded configuration;

Figure 18 C is the schematic side elevation view of the anchor log assembly shown in Figure 18 B, shows the actuating of locking component and the joint in dissection gap;

Figure 18 D is the schematic side elevation view of the anchor log assembly shown in Figure 18 C, shows the locking of locking component;

Figure 18 E is the schematic side elevation view of the anchor log assembly shown in Figure 18 D, shows the configuration that finally assembles;

Figure 19 A is the schematic cross-sectional side front view of the maintenance assembly of the insertion apparatus of constructing according to another embodiment, is depicted as to be in locked configuration;

Figure 19 B is the schematic cross-sectional side front view of the maintenance assembly of the insertion apparatus shown in Figure 19 A, is depicted as to be in unlocked configurations;

Figure 19 C is the sectional side front view of the housing of insertion apparatus, and it is similar with the insertion apparatus shown in Figure 12 C that this inserts apparatus, but comprises the maintenance assembly according to alternative embodiment structure;

Figure 20 A is according to the sectional side front view of the insertion apparatus that comprises cutting assembly of another embodiment, shows the cutting assembly that is in disengaging configuration;

Figure 20 B is the sectional side front view of the insertion apparatus shown in Figure 20 A, but shows the cutting assembly that is in bonding station;

Figure 21 A is the sectional side front view of the insertion apparatus shown in Figure 20 A, but described insertion apparatus comprises according to another embodiment and constructs and be depicted as the cutting assembly that is in disengaging configuration;

Figure 21 B is the sectional side elevation of the insertion apparatus shown in Figure 21 A, but shows the cutting assembly that is in bonding station;

Figure 22 A is the perspective view of the insertion apparatus shown in Fig. 7 A, but described insertion apparatus constructs according to alternative embodiment, and is depicted as and is in primary importance;

Figure 22 B is the side front view of the insertion apparatus shown in Figure 22 A;

Figure 22 C is the side front view of the insertion apparatus shown in Figure 22 B, is in the second position but be depicted as;

Figure 22 D is the side front view of the insertion apparatus shown in Figure 22 C, is in the 3rd position but be depicted as;

Figure 23 A for with the perspective view that inserts the insertion apparatus that the similar mode of apparatus constructs shown in Fig. 7 A, but described insertion apparatus constructs according to another embodiment, and is depicted as and is in primary importance;

Figure 23 B is the perspective view of the plunger of the insertion apparatus shown in Figure 23 A;

Figure 23 C is the perspective view of the far-end of the insertion apparatus shown in Figure 23 A;

Figure 23 D is the perspective view of each parts of the insertion apparatus shown in Figure 23 A, and described insertion apparatus comprises the plunger shown in Figure 23 B, push rod and a pair of first coupling member;

Figure 23 E is the perspective view that is configured to second coupling member that engages with first coupling member shown in Figure 23 D;

Figure 23 F is the perspective view of the insertion apparatus shown in Figure 23 A, is depicted as to be in the second position;

Figure 23 G is the perspective view of the insertion apparatus shown in Figure 23 F, is depicted as to mediate;

Figure 23 H is the perspective view of the insertion apparatus shown in Figure 23 G, is depicted as to be in the 3rd position;

Figure 24 A is for inserting the perspective view of apparatus, and described insertion apparatus comprises the first pusher assembly and the second pusher assembly that arranges with side by side relationship, shows each the pusher assembly that is in primary importance;

Figure 24 B is after the first pusher assembly removal, first locking tab, the perspective view of the insertion apparatus shown in Figure 24 A;

Figure 24 C is after the first pusher assembly is actuated to the second position, the perspective view of the insertion apparatus shown in Figure 24 B;

Figure 24 D is after the second pusher assembly removal, second locking tab, the perspective view of the insertion apparatus shown in Figure 24 C;

Figure 24 E is after activating the exchange actuator, the perspective view of the insertion apparatus shown in Figure 24 D;

Figure 24 F is after the second pusher assembly is actuated to the second position, the perspective view of the insertion apparatus shown in Figure 24 E;

Figure 25 A is the perspective view of the parts of the insertion apparatus shown in Figure 24 A, shows the first pusher assembly that is in primary importance and each in the second pusher assembly;

Figure 25 B is after the first pusher assembly being actuated to the second position, the perspective view of the parts of the insertion apparatus shown in Figure 25 A;

Figure 25 C is after activating the exchange actuator, the perspective view of the parts of the insertion apparatus shown in Figure 25 B;

Figure 25 D is after the second pusher assembly being actuated to the second position, the perspective view of the parts of the insertion apparatus shown in Figure 25 C;

Figure 26 A is the perspective view according to the maintenance assembly of an embodiment structure;

Figure 26 B is the enlarged perspective of the part of the maintenance assembly shown in Figure 26 A;

Figure 27 A is the perspective view of the insertion apparatus of constructing according to another embodiment, and described insertion apparatus comprises the first pusher assembly and the second pusher assembly that arranges with side by side relationship, shows each in the pusher assembly that is in primary importance;

Figure 27 B is after the first pusher assembly being actuated to the location configuration, the perspective view of the insertion apparatus shown in Figure 27 A;

Figure 27 C be for will exchange actuator after primary importance is actuated into actuated position, the perspective view of the parts of the insertion apparatus shown in Figure 27 B;

Figure 27 D is after the second pusher assembly is actuated to the second position, the perspective view of the insertion apparatus shown in Figure 27 C;

Figure 28 A is the perspective view of the parts of the insertion apparatus shown in Figure 27 A, is depicted as to have the exchange actuator that is in primary importance;

Figure 28 B is the perspective view of the parts of the insertion apparatus shown in Figure 28 A, is depicted as to have the exchange actuator that is in the second position;

Figure 29 A is the perspective view of the insertion apparatus of constructing according to another embodiment, and described insertion apparatus comprises the first pusher assembly and the second pusher assembly that arranges with side by side relationship, shows each in the pusher assembly that is in primary importance;

Figure 29 B is the end elevational view of the insertion apparatus shown in Figure 29 A;

Figure 29 C is the perspective view of the insertion apparatus shown in Figure 29 A, shows the first pusher assembly that is in the second position;

Figure 29 D be for will exchange actuator after primary importance is actuated into the second position, the perspective view of the insertion apparatus shown in Figure 29 C;

Figure 29 E is after the second pusher assembly removal locking tab, the perspective view of the insertion apparatus shown in Figure 29 D;

Figure 29 F is the perspective view of the insertion apparatus shown in Figure 29 E, shows the second pusher assembly that is in the second position;

Figure 29 G is the schematic cross-sectional end elevational view of the insertion apparatus shown in Figure 29 D, shows the part of exchange actuator;

Figure 30 A is the perspective view of the insertion apparatus of constructing according to another embodiment, described insertion apparatus comprises the first reciprocating intubate and the second reciprocating intubate, and the part that accompanying drawing illustrates housing is cut off in order to expose the internal part that inserts apparatus;

Figure 30 B is the perspective view of the reciprocating motion assembly of the insertion apparatus shown in Figure 30 A, and described reciprocating motion assembly is configured to reciprocally drive first intubate and second intubate;

Figure 30 C is the perspective view of the drive member of the reciprocating motion assembly shown in Figure 30 B;

Figure 30 D is the perspective view of selectivity plunger conjugative component, described selectivity plunger conjugative component be configured to operationally be communicated with first intubate and with mobile plunger optionally between second intubate operationally is communicated with;

Figure 31 is for inserting the perspective view of apparatus, and wherein intubate limits side according to another embodiment and ejects port;

Figure 32 A is for according to the perspective view that enters assembly of an embodiment, and the described assembly that enters comprises and enters member and opening forms member;

Figure 32 B is the side sectional view that enters member shown in Figure 32 A;

Figure 32 C is the side front view of the awl shown in Figure 32 A;

Figure 32 D is according to alternative embodiment, the side front view of the part of the awl shown in Figure 32 C;

Figure 32 E is for inserting the perspective view that enters assembly of target anatomical position;

Figure 32 F is for inserting the perspective view that enters member of target anatomical position;

Figure 32 G is the perspective view according to the anchor log inserter assembly of an embodiment, and described anchor log inserter assembly comprises anchor log shell and the pusher member that enters member, carrying anchor log;

Figure 32 H is the side sectional view of the anchor log shell shown in Figure 32 G;

Figure 32 I is the side sectional view of the anchor log inserter assembly shown in Figure 32 G, and wherein anchor log does not eject from entering member as yet;

Figure 32 J is the side sectional view of the pusher member shown in Figure 32 G;

Figure 32 K is the side sectional view of the anchor log inserter assembly shown in Figure 32 G, and wherein pusher member is pushed into, and makes anchor log eject from entering member;

Figure 32 L is the perspective view of the anchor log that expands with the target anatomical position;

Figure 32 M is the side sectional view of the anchor log assembly of constructing according to alternative embodiment;

Figure 33 A is the perspective view according to the anchor log inserter assembly of alternative embodiment, and described anchor log inserter assembly comprises anchor log shell and the tension force assembly that enters member, carrying anchor log;

Figure 33 B is the side front view of the parts of the tension force assembly shown in Figure 33 A;

Figure 33 C is a perspective view, shows the parts of the tension force assembly shown in Figure 33 A before the tension force assembly is operated to the anchor log expansion;

Figure 33 D is a perspective view, shows the parts of the tension force assembly shown in Figure 33 A after the tension force assembly has been operated to the anchor log expansion;

Figure 34 A is the perspective view according to the anchor log inserter assembly of another alternative embodiment, and described anchor log inserter assembly comprises anchor log shell and the tension force assembly that enters member, carrying anchor log;

Figure 34 B is the side sectional view of the parts of tension force assembly;

Figure 34 C is a perspective cutaway view,, shows the parts of the tension force assembly shown in Figure 34 A before the tension force assembly is operated to the anchor log expansion;

Figure 34 D is a perspective cutaway view,, shows the parts of the tension force assembly shown in Figure 34 A after the tension force assembly has been operated to the anchor log expansion;

Figure 35 A is the decomposition diagram that enters assembly according to another alternative embodiment, and anchor log inserter assembly comprises awl and enters member;

Figure 35 B is the decomposition diagram according to the anchor log inserter assembly of the alternative embodiment shown in Figure 35 A, and described anchor log inserter assembly comprises anchor log shell and the tension force assembly that enters member, carrying anchor log;

Figure 36 A is the perspective view that enters assembly that comprises the awl shown in Figure 35 and enter member;

Figure 36 B is the side sectional view that enters assembly shown in Figure 36 A;

Figure 37 A is the perspective view that comprises the anchor log inserter assembly of the anchor log shell that enters member, carrying anchor log shown in Figure 35 and tension force assembly, and described anchor log inserter assembly is configured to operate with first pattern;

Figure 37 B is the profile perspective of the anchor log inserter assembly shown in Figure 37 A;

Figure 38 is the perspective view of the anchor log inserter assembly shown in Figure 37 A, and described anchor log inserter assembly is configured to be in translation member the anchor log expansion mechanism operation of middle position;

Figure 39 is the perspective view of anchor log inserter assembly shown in Figure 38, and wherein translation member is in extended position;

Figure 40 A is the perspective view of the translation member of constructing according to alternative embodiment;

Figure 40 B is the front view of the translation member of constructing according to another alternative embodiment;

Figure 41 A is the perspective view of the translation member of constructing according to another alternative embodiment;

Figure 41 B is the front view of the translation member shown in Figure 41 A;

Figure 42 is the cross sectional elevation of the translation member of constructing according to another alternative embodiment;

Figure 43 is the cross sectional elevation of the translation member of constructing according to another alternative embodiment;

Figure 44 A-44C shows the various views that are configured to actuation member is fixed to the anchor clamps of translation member;

Figure 45 is the perspective view of the insertion apparatus of constructing according to another embodiment, described insertion apparatus is configured to insert and make a pair of anchor log main body expansion in corresponding target location, described insertion apparatus comprises shell, and described shell comprises first main body and second main body;

Figure 46 is the decomposition diagram of first main body, comprises that pusher member and opening form member;

Figure 47 A is the perspective view of first main body shown in Figure 46, and it is depicted as and is in its retracted configuration;

Figure 47 B is the perspective view of the actuator of first main body shown in Figure 47 A, shows the actuator that is in primary importance;

Figure 47 C is the perspective view of the far-end of first main body shown in Figure 47 A;

Figure 48 A is the perspective view of first main body shown in Figure 46, and it is depicted as and is in extended configuration;

Figure 48 B is the perspective view of the actuator of first main body shown in Figure 48 A, shows the actuator that is in the second position;

Figure 48 C is the perspective view of the far-end of first main body shown in Figure 48 A;

Figure 49 A is the perspective view of the anchor log box of constructing according to an embodiment;

Figure 49 B is another perspective view of the anchor log box shown in Figure 49 A, and the part of described anchor log box is hidden in order to a pair of anchor log that is supported by the anchor log box is shown;

Figure 50 A is the top plan view of the part of the insertion apparatus shown in Figure 45, the opening formation member that shows the anchor log box shown in Figure 49 B that is in initial position and extend through the anchor log box;

Figure 50 B is the top plan view of the described part of the insertion apparatus shown in Figure 50 A, but shows the opening formation member of withdrawal;

Figure 50 C is the top plan view of the described part of the insertion apparatus shown in Figure 50 B, but shows the anchor log box that is arranged on primary importance;

Figure 50 D is the top plan view of the described part of the insertion apparatus shown in Figure 50 C, but shows the pusher member that extends through the anchor log box;

Figure 50 E is the top plan view of the described part of the insertion apparatus shown in Figure 50 D, but shows the pusher member of withdrawal;

Figure 50 F is the top plan view of the described part of the insertion apparatus shown in Figure 50 E, but shows the backstop folder that removes;

Figure 50 G is the top plan view of the described part of the insertion apparatus shown in Figure 50 F, but shows the anchor log box that is in the second position;

Figure 50 H is the top plan view of the described part of the insertion apparatus shown in Figure 50 G, but shows the pusher member that extends through the anchor log box;

Figure 51 A is the decomposition diagram of the tension force assembly (tension assembly) of insertion apparatus shown in Figure 45;

Figure 51 B is the sectional side front view of the tension assembly shown in Figure 51 A (tensioning assembly), is depicted as to be in primary importance;

Figure 51 C is the sectional side front view of the tension assembly shown in Figure 51 B of online 51C place intercepting;

Figure 51 D is the cross section end elevational view of the tension assembly shown in Figure 51 B;

Figure 51 E is the sectional side front view of the tension assembly shown in Figure 51 A, is depicted as to be in the second position;

Figure 51 F is the sectional side front view exploded view of the tension assembly shown in Figure 51 E of online 51F place intercepting;

Figure 51 G is the sectional side front view of the tension assembly shown in Figure 51 A, is depicted as to be in the 3rd position;

Figure 51 H is the sectional side front view exploded view of the tension assembly shown in Figure 51 G of online 51H place intercepting;

Figure 51 I is the cross section end elevational view of the tension assembly shown in Figure 51 G;

Figure 52 A is the perspective view of the insertion apparatus shown in Figure 45, and described insertion apparatus is configured to insert first target location;

Figure 52 B is the perspective view of the insertion apparatus shown in Figure 52 A, is depicted as to insert first target location in order to form first opening;

Figure 52 C is the perspective view of the insertion apparatus shown in Figure 52 B, but shows the open pointed tip of withdrawal;

Figure 52 D is the perspective view of the insertion apparatus shown in Figure 52 C, but shows the pusher member of withdrawal;

Figure 53 A is the perspective view of the insertion apparatus shown in Figure 52 D, but shows the anchor log box that is in primary importance;

Figure 53 B is the perspective view of the insertion apparatus shown in Figure 53 A, but shows the first anchor log main body of inserting first opening;

Figure 53 C is the perspective view of the insertion apparatus shown in Figure 53 B, activated so that the tension assembly that the anchor log main body of inserting expands but show;

Figure 53 D is the perspective view of the insertion apparatus shown in Figure 53 C, but shows the tension assembly that is in primary importance;

Figure 53 E is the perspective view of the insertion apparatus shown in Figure 53 D, is depicted as from first target location to remove;

Figure 54 A is the perspective view of the insertion apparatus shown in Figure 53 E, and described insertion apparatus is configured to insert second target location;

Figure 54 B is the perspective view of the insertion apparatus shown in Figure 54 A, is depicted as to insert second target location in order to form second opening;

Figure 54 C is the perspective view of the insertion apparatus shown in Figure 54 B, but shows the open pointed tip of withdrawal;

Figure 54 D is the perspective view of the insertion apparatus shown in Figure 54 C, but shows the pusher member of withdrawal;

Figure 55 A is the perspective view of the insertion apparatus shown in Figure 54 D, but shows the backstop folder that removes from the anchor log box;

Figure 55 B is the perspective view of the insertion apparatus shown in Figure 55 A, but shows the anchor log box that is in the second position;

Figure 55 C is the perspective view of the insertion apparatus shown in Figure 55 B, but shows the second anchor log main body of inserting second opening;

Figure 55 D is the perspective view of the insertion apparatus shown in Figure 55 C, activated so that the tension assembly that the second anchor log main body of inserting expands but show;

Figure 55 E is the perspective view of the insertion apparatus shown in Figure 55 D, but shows the tension assembly that is in primary importance;

Figure 55 F is the perspective view of the insertion apparatus shown in Figure 55 E, is depicted as from second target location to remove;

Figure 56 A is the side front view of the inflatable grappling part of constructing according to another embodiment, and described inflatable grappling part has the anchor log main body and activates strand, shows the anchor log main body that is in first configuration;

Figure 56 B is the side front view of the inflatable grappling part shown in Figure 56 A, shows the anchor log main body that is in expanded configuration;

Figure 57 A is the side front view that is used to form first method step of the anchor log main body shown in Figure 56 A, shows the structure of eyelet;

Figure 57 B-C shows the method step that is used to form eyelet shown in Figure 57 A according to an embodiment;

Figure 57 D shows the method step that is used to form eyelet shown in Figure 57 A according to an embodiment;

Figure 57 E shows the method step that is used to form eyelet shown in Figure 57 A according to an embodiment;

Figure 57 F-L shows the method step that is used to form eyelet shown in Figure 57 A according to an embodiment;

Figure 58 A is the perspective view that is used to form second method step of the anchor log main body shown in Figure 56 A, shows first knot around eyelet shown in mandrel tying-up Figure 57 A;

Figure 58 B is another perspective view of second method step shown in Figure 58 A;

Figure 58 C is the perspective view that is used to form third party's method step of the anchor log main body shown in Figure 56 A, shows second knot relative with first knot;

Figure 58 D is another perspective view of the third party's method step shown in Figure 58 D;

Figure 58 E is the perspective view that is used to form the method step of the anchor log main body shown in Figure 56 A, shows toward each other alternately a plurality of knots of tying-up;

Figure 58 F is another perspective view of method step shown in Figure 58 E;

Figure 58 G is the perspective view of the anchor log main body that centers on the mandrel setting shown in Figure 56 A;

Figure 58 H is the perspective view of the anchor log main body shown in Figure 58 G, shows by eyelet and the actuating strand that inserts by mandrel;

Figure 58 I is the anchor log main body shown in Figure 58 H and the perspective view that activates strand, shows the actuating strand that is driven through the anchor log main body;

Figure 58 J is the anchor log main body shown in Figure 58 I and the perspective view that activates strand, shows the eyelet that is driven through the anchor log main body;

Figure 59 is the perspective view with the similar inflatable grappling part of inflatable grappling part shown in Figure 56 A, but shows the knot that is configured as the anchor log main body of anticreep knot, and this moment, eyelet was not drawn in the expandable part of anchor log main body as yet;

Figure 60 A is the perspective view with the similar inflatable grappling part of inflatable grappling part as shown in Figure 56 A, but shows the anchor log main body that comprises a pair of eyelet, and this will be drawn in the expandable part of anchor log main body to eyelet subsequently;

Figure 60 B is the perspective view of the inflatable grappling part shown in Figure 60 A, shows the anchor log main body that is in expanded configuration.

The specific embodiment

At first referring to Figure 1A-B, anchor log assembly 20 can comprise at least one inflatable grappling part 22, the for example first inflatable grappling part 22a and the second inflatable grappling part 22b, and the first inflatable grappling part 22a and the second inflatable grappling part 22b comprise corresponding anchor log main body 28a and 28b, anchor log main body 28a and 28b are configured to be fixed to anatomical position, and described anatomical position can be limited by at least one anatomical structure 24.Anatomical structure 24 can be by the dissection of for example human or other animals, or is fixed to or the implant that is configured to be fixed to the dissection of the mankind or other animals limits.Dissection can be limited by tissue, and described tissue can comprise at least one in bone and the soft tissue (for example the fibrous ring of tendon, ligament, cartilage, intervertebral disc etc.).

According to an embodiment, at least one anatomical structure 24 can limit and be positioned at the gap, for example the first target anatomical position 24a on the opposite side of gap 24c and the second target anatomical position 24b.Therefore, gap 24c can be arranged in the anatomical structure, and it is damaged for example to limit dissection, maybe can be arranged between the different anatomical structures.The first anchor log 22a and the second anchor log 22b can be launched into, or in other words driven or be inserted into the corresponding first target anatomical position 24a and the second target anatomical position 24b on the opposite side that is arranged in gap 24c, and subsequently by tractive toward each other with near gap 24c.Alternatively or in addition, anchor log assembly 20 can be configured to supplementary structure is fixed to anatomical structure.In this regard, it is also understood that anchor log assembly 20 can comprise any amount of anchor log 22 as required.

Each anchor log main body 28a and 28b can comprise corresponding expandable part 36a and 36b and actuation member 37a and 37b, for example activate strand 38a and 38b, actuation member 37a and 37b are configured to corresponding expandable part 36a and 36b, and corresponding anchor log main body 28a and 28b, be actuated to the expanded configuration shown in Figure 1B from first configuration shown in Figure 1A, by first configuration shown in Figure 1A, anchor log main body 28a and 28b initially are arranged on target anatomical position place, and by the expanded configuration shown in Figure 1B, corresponding anchor log main body 28a and 28b can be fixed to anatomical structure 24.Therefore, can pass through anchor log main body 28a and the 28b that opening 23 inserts anchor log 22a and 22b at corresponding target anatomical position 24a and 24b place, can be for example when anchor log main body 28a and 28b are sent to corresponding target anatomical position 24a and 24b, for example by with anchor log main body 28a with 28b is incident upon corresponding target anatomical position 24a and 24b realizes described insertion.

The expandable part 36 of anchor log main body 28 extends along prolonging direction 34, the initial distance D1 that measures to far-end 39b along prolonging direction 34 from near-end 39a when being in first configuration to be limited to.Initial distance D1 can be any length as required, this length is in a scope, this scope has can be by about 5mm or approximately 10mm or approximately 20mm or the approximately lower end that limits of 24.5mm, and can be by about 50mm or approximately 40mm or the approximately upper end that limits of 30mm or about 25.5mm.

In addition, when being in first configuration, expandable part 36 is limited to the initial maximum thickness T1 that extends on the second direction 35, and second direction 35 is with respect to prolonging direction 34 perpendicular.Can set the size of initial maximum thickness T1 as required.As shown in Figure 1B, when expandable part 36 was in expanded configuration, expandable part 36 shrank (for example compression or entanglement) to the second distance D2 that measures to far-end 39b along prolonging direction 34 from near-end 39a along prolonging direction 34.Second distance D2 can be less than initial distance D1.When expandable part 36 shrank along prolonging direction, for example when expandable part 36 is actuated to expanded configuration from first configuration, expandable part 36 was expanded to the second maximum ga(u)ge T2 greater than initial maximum thickness T1 along second direction 35.The second maximum ga(u)ge T2 extends along the second direction 35 that is substantially perpendicular to prolonging direction 34.

Maximum ga(u)ge T1 and T2 on the second direction 35 can be defined, and make anchor log main body 28 not be limited on the second direction 35 respectively the thickness greater than maximum ga(u)ge T1 and T2.For example should be appreciated that since when being in expanded configuration the configuration of expandable part 36, when expandable part 36 was actuated to expanded configuration, near-end 39a and far-end 39b can change the position on expandable part 36.Yet, when expandable part 36 is in expanded configuration, near-end 39a and far-end 39b continue to limit most proximal end and the distal-most end of expandable part 36, make when expandable part 36 is in expanded configuration, be limited at as the crow flies between the near-end 39a and far-end 39b of expandable part 36 along the distance B 2 of prolonging direction 34.

Every of the first anchor log 22a and the second anchor log 22b activates strand 38 and can be attached to one another.For example, the actuating strand 38 of the first anchor log 22a can be in aggregates with the actuating strand 38 of the second anchor log 22b.Alternatively, as describing in more detail in conjunction with Fig. 2 A-C hereinafter, the actuating strand 38 of the first anchor log 22a can separate with the actuating strand 38 of the second anchor log 22b, makes to use any suitable connector members 63 to come the actuating strand 38 of the attached first anchor log 22a and the actuating strand 38 of the second anchor log 22b directly or indirectly subsequently.Connector members 63 can be in aggregates with the one or both that activates among strand 38a and the 38b, perhaps can with activate among strand 38a and the 38b any one is attached separately.According to an embodiment, the actuating strand 38a of each and 38b limit at least one corresponding actuation part 131a and 131b among the first anchor log 22a and the second anchor log 22b, and can comprise at least one corresponding attachment part 133a and 133b.Actuation part 131a and 131b be corresponding to be configured to receive actuation force, and described actuation force makes corresponding anchor log 22a and 22b be actuated to expanded configuration from first configuration.

In accordance with the embodiments illustrated, the actuating strand 38a of first anchor log and second anchor log and the attachment part 133a of 38b and 133b are configured to be attached to one another, thereby stride across gap 24c and the first anchor log main body 28a is attached to the second anchor log main body 28b.Attachment part 133a and 133b can be integrally with each other, or use any suitable connector members to be attached to one another.In addition, in accordance with the embodiments illustrated, actuation part 131a and 131b also can limit and be configured to the attachment part that was attached to one another with any suitable method before or after actuation force F is applied to actuation part 131a and 131b.Therefore, attachment part 133a and the 133b of corresponding anchor log 22a and 22b are configured to corresponding anchor log is attached to another anchor log (for example attachment part of another anchor log).In addition, the actuation part 131a of the first anchor log 22a is configured to corresponding anchor log 22a is attached to the second anchor log 22b.In accordance with the embodiments illustrated, the attachment part 133b of the attachment part 133a of the actuating strand 38a of the first anchor log 22a and the actuating strand 38b of the second anchor log 22b is in aggregates, but be to be understood that, as described in more detail below, the attachment part 133a of the first anchor log 22a and the second anchor log 22b and 133b can be separated from one another and be attached to each other.

Continuation is referring to Figure 1A-B, in case the expandable part 36a-b of anchor log 22a-b has been actuated to expanded configuration, activates strand 38a-b and just can be set to tensioning state.For example, according to an embodiment, engaging force AF can be applied to any one or both of actuation part 131a-b of the actuating strand 38a-b of first anchor log and the second anchor log 22a-b, thereby the actuating strand 38a-b that lures first anchor log and the second anchor log 22a-b into produces tension force, to apply the first anchor log 22a and the second anchor log 22b towards the bias force of tractive each other.Therefore, if gap 24c is arranged between the first anchor log 22a and the second anchor log 22b, then anchor log 22a and 22b in response to bias force towards each other motion with joint clearance 24c, in certain embodiments, it is damaged that gap 24c can be dissection, for example aforesaid tissue defect.

In addition, when after damaged 24 have engaged, activating strand 38a-b and maintain tensioning state, prevent anchor log main body 28a-b by corresponding target location 24a-b from the dissection rollback, target location 24a-b is may allowable clearance 24c open.Therefore, in case gap 24c engages, the actuating strand 38a of the first anchor log 22a just can be attached to the actuating strand 38b of the second anchor log 22b, in order to keep tensioning and prevent that the first anchor log 22a from separating with the second anchor log 22b between the first anchor log 22a and the second anchor log 22b.

Anchor log main body 28a and 28b can weave any suitable substrates (strand for example is as sewing up the strand of usefulness) by the mode with any needs and construct, and described mode makes and produces a plurality of openings 43 that extend through corresponding anchor log main body 28a and 28b.First activates strand 38a and second activates at least two that strand 38b can pass in the opening 43 along the prolonging direction 34 of anchor log main body 28a and 28b and weaves.

According to the embodiment shown in Figure 1A-1F, it is in aggregates that the first actuating strand 38a and second activates strand 38b and the corresponding first anchor log main body 28a and the second anchor log main body 28b.According to other embodiment, first activate strand 38a and second activate strand 38b be depicted as separate with the second anchor log main body 28b with the corresponding first anchor log main body 28a and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b(referring to Fig. 2 C).According to other embodiment, first activates strand 38a and second, and to activate one among the strand 38b in aggregates with corresponding anchor log main body, and first activate strand 38a and second activate among the strand 38b another person and corresponding anchor log body portion from and be attached to corresponding anchor log main body.Activating strand 38a and second according to first activates strand 38b and is illustrated and is described as the embodiment in aggregates with the corresponding first anchor log main body 28a and the second anchor log main body 28b, be to be understood that, except as otherwise noted, activate strand 38b and can or separate with the second anchor log main body 28b with the corresponding first anchor log main body 28a otherwise first activates strand 38a and second, and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b.In addition, activate strand 38a according to first and activate the embodiment that strand 38b is illustrated and is described as to separate and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b the corresponding first anchor log main body 28a and the second anchor log main body 28b with second, be to be understood that, except as otherwise noted, otherwise first activate strand 38a and second activate strand 38b can or in aggregates with the corresponding first anchor log main body 28a and the second anchor log main body 28b.

Referring to Fig. 1 C-1F, anchor log assembly 20 can comprise at least one connector members 63, described at least one connector members 63 is configured to connect anchor log 22, and allow bias force is applied among anchor log 22a and the 22b at least one so that anchor log 22a and 22b are moved to together, dissect damaged 24 thereby engage.Connector members 63 can with the first anchor log 22a and the second anchor log 22b in one or both in aggregates, for example in aggregates with first one or both that activates among strand 38a and the second actuating strand 38b, can with the first anchor log main body and the second anchor log main body in one or both in aggregates, perhaps can separate with the one or both among the second anchor log 22b with the first anchor log 22a and (directly or indirectly) is attached to one or both among the first anchor log 22a and the second anchor log 22b.For example, as describing in more detail hereinafter, connector members 63 can separate with the first anchor log 22a and the second anchor log 22b and be attached between the first anchor log 22a and the second anchor log 22b.Although connector members 63 is described according to each embodiment as this paper, should be appreciated that anchor log assembly 20 can or comprise any suitable connector members that is configured to the first anchor log 22a is attached to the second anchor log 22b.

Anchor log assembly 20 can comprise the connector members 63 in aggregates with corresponding actuating strand 38a and 38b.As mentioned above, the corresponding first target anatomical position 24a and the second target anatomical position 24b place that each among the first anchor log main body 28a and the second anchor log main body 28b can be on the opposite side that is arranged at the gap 24c shown in Fig. 2 A is implanted.First activates strand 38a and second activates among the strand 38b each and can receive basically actuation force F along prolonging direction 34, this actuation force F makes the corresponding first anchor log main body 28a and the second anchor log main body 28b(be in particular corresponding expandable part 36a and 36b) be actuated to expanded configuration from first configuration, thus the first anchor log main body 28a and the second anchor log main body 28b are fixed on the corresponding first target anatomical position 24a and the second target anatomical position 24b place.Be applied to and activate the form that the actuation force F of each among strand 38a and the 38b can be different actuation forces, perhaps can be identical actuation force.

For example, referring to Fig. 1 C-1D, connector members 63 can be configured to subconnector member 77, namely, separate with second one or both that activates among the strand 38b with the first actuating strand 38a, and be configured to make the first actuating strand 38a and second to activate the connector members that strand 38b is attached to one another.For example, subconnector member 77 can be made by any suitable metal, plastics or any alternative biocompatible materials, and can be configured to the main body 146 of flexibility or rigidity, described main body 146 can be configured to position between anchor log 22a and 22b and be attached to first and activate strand 38a and second and activate any one or both among the strand 38b, is attached to actuation part 131a-b particularly.For example, can pass each that main body 146 is sewed up among the first actuation part 131a and the second actuation part 131b, and around main body 146 tying-ups, thereby the knot 148 that can be actuated to locked configuration from unlocked configurations limited.The first actuation part 131a and the second actuation part 131b can slide with respect to main body 146 when knot 148 is in unlocked configurations, and the sliding motion with respect to relative main body 146 is fixing when knot 148 is in locked configuration.Main body 146 can limit Any shape as required, substantial cylindrical for example, and can be flexible as required or rigidity roughly.

During operation, can sew up actuation part 131a-b along passing main body 146 away from the direction of anatomical structure 24, and around main body 146 tying-ups, make corresponding knot 148 be in unlocked configurations.Main body 146 can be oriented to and make its major axis 149 be arranged essentially parallel to anatomical structure 24 to be orientated.Be in tension force following time activating strand 38a and 38b, can activate strand 38a and second along first along the direction of arrow 150 and activate strand 38b towards anatomical structure 24 translatable body 146, this make activate strand 38a and 38b along by the rightabout of arrow 152 indications with respect to main body 146 translations.When activating strand 38a and 38b towards gap 24c translation on main body 146 edges, main body 146 is applied to actuation force F and activates strand 38a and 38b, and then makes anchor log 22a and 22b be actuated to expanded configuration from first configuration.

When main body after anchor log 22a and 22b have been actuated to its expanded configuration during towards the further translation of gap 24c, main body 146 is applied to engaging force AF at least one or both that activate among strand 38a and the 38b, with with at least one or both among anchor log 22a and the 22b towards the inside tractive of another person, and then joint clearance 24c.In this, should be appreciated that engaging force AF can be the continuity of actuation force F.Perhaps, can or will activate at the upstream position of main body 146 before strand 38a and 38b be attached to main body 146, and actuation force F be applied to activate strand 38a and 38b.Can make knot 148 fastening subsequently, so that being activated strand 38b, the first actuating strand 38a and second is fixed to main body 146, and it is fixed to one another therefore also to make the first actuating strand 38a and second activate strand 38b, thereby prevent that the first anchor log 22a from separating with the second anchor log 22b.In case gap 24c engages, main body 146 and and then tie 148, just can be along the outer surface setting of anatomical structure 24.Alternatively, make gap 24c engage in case the size of main body 146 can be set for, the part of main body 146 and and then tie 148, just be arranged in the opening 23 that holds anchor log main body 28a and 28b.Therefore, knot 148 can be arranged on anatomical structure 24 rears, maybe can embed in the anatomical structure 24.

Therefore main body 146 can limit sliding component 47, and can limit locking component 64, sliding component 47 allows first another persons that activate among the strand 38b with respect to the first actuating strand 38a and second that activate among strand 38a and the second actuating strand 38b to slide with joint clearance 24c, and locking component 64 is for example with respect to the relative motion that allows the first anchor log 28a to separate with the second anchor log 28b, and it is fixed to one another that the first actuating strand 38a and second is activated strand 38b.

Referring now to Fig. 1 E-1F,, anchor log assembly 20 can comprise pair of connectors member 63a and 63b, and this connector members is configured at least one or both among actuation part 131a and the 131b are attached to corresponding attachment part 133a and 133b.In accordance with the embodiments illustrated, activate strand 38a and 38b by limiting for the common actuation member (for example sharing strand) of auxiliary strand 33, at least one (for example a pair of or a plurality of) opening that auxiliary strand 33 can separate with the second anchor log main body 28b with the first anchor log main body 28a and pass among the first anchor log main body 28a and the second anchor log main body 28b weaves, and makes that corresponding attachment part 133a and 133b are integrally with each other.Therefore, in accordance with the embodiments illustrated, it is integrally with each other that the first actuating strand 38a and second activates strand 38b.Anchor log assembly 20 can comprise the first connector members 63a and the second connector members 63b, this first connector members and second connector members limit by activating strand 38a and 38b, and be configured to actuation part 131a and 131b are attached to other positions that share strand, and therefore be attached to one another.In accordance with the embodiments illustrated, the first connector members 63a can be attached to the first actuation part 131a of correspondence the another location with the isolated auxiliary strand 33 of the first actuation part 131a.Equally, the second connector members 63b can be attached to the second actuation part 131b of correspondence the another location with the isolated auxiliary strand 33 of the second actuation part 131b.For example, in accordance with the embodiments illustrated, the first connector members 63a is attached to the first attachment part 133a with the first actuation part 131a, and the second connector members 63b is attached to the second attachment part 133b with the second actuation part 131b.

Therefore we can say, at least one connector members, the for example first connector members 63a and the second connector members 63b, the first actuation part 131a and the second actuation part 131b can be attached to corresponding other positions of auxiliary strand 33, thereby the first actuation part 131a and the second actuation part 131b for example are attached to one another by at least one or both among attachment part 133a and the 133b indirectly.Can also say, the first connector members 63a operationally is attached to first another location that activates strand 38a with first part that activates strand 38a, and the second connector members 63b operationally is attached to second another location that activates strand 38b with second part that activates strand 38b.Should be appreciated that perhaps the first connector members 63a and the second connector members 63b can be attached to anchor log main body 28 with the corresponding first actuation part 131a and the second actuation part 131b, for example at corresponding first end portion 52 and second end portion, 54 places.Be depicted as separated from one anotherly although activate strand 38a and 38b, activating strand 38a and 38b can or for example be attached to one another via any suitable connector members 63 of type described herein, thus restriction outconnector strand.

In accordance with the embodiments illustrated, corresponding knot 66a and the 66b that auxiliary strand 33 limits that can be configured to serve as reasons of each among the first connector members 63a and the second connector members 63b.In accordance with the embodiments illustrated, the first knot 66a comprises rear end 68 and free end, rear end 68 can be limited by the first actuation part 131a that activates strand 38a, free end can comprise the static part 70a that the first terminal 137a by the first actuation part 133a limits, and the free part 70b that is limited by the second terminal 139a of the first actuation part 133a.The first terminal 137a can be arranged between knot 66a and the first anchor log main body 28a, and the second terminal 139a can be arranged between knot 66a and the second connector members 63b.Perhaps, free part 70b can be limited by the second attachment part 133b that activates strand 38b.

According to an embodiment, the second knot 66b comprises rear end 68 and free end, rear end 68 can be limited by the second actuation part 131b that activates strand 38b, free end can comprise the static part 70a that the first terminal 137b by the second actuation part 133b limits, and the free part 70b that is limited by the second terminal 139b of the second actuation part 133b.The first terminal 137b can be arranged between knot 66b and the second anchor log main body 28b, and the second terminal 139b can be arranged between knot 66b and the first connector members 63a.Perhaps, free part 70b can be limited by the first attachment part 133a that activates strand 38a.Attachment part 133a and 133b are depicted as integrally with each other, but should be appreciated that attachment part 133a and 133b can be separated from one another and attached as required.

The first knot 66a and second knot each among the 66b can limit corresponding sliding component 47, described sliding component 47 allow corresponding rear end 68 with respect to free end from wherein translating across.Therefore, sliding component 47 for example allows the first actuation part 131a and the second actuation part 131b() in response to the actuation force F that when knot 66a and 66b are in unlocked configurations, applies with respect to the first actuation part 133a and the second actuation part 133b translation, thereby corresponding anchor log main body 28a and 28b are actuated to expanded configuration from first configuration.Each knot 66 also limits locking component 64, and this locking component is actuatable to locked configuration, thereby at least one or both among anchor log 22a and the 22b are fixed on its corresponding offset position.For example, the stretching latching force can be applied to the free-ended free part 70b of knot 66a and 66b, translate across knot 66a and 66b to prevent actuation part 131a and 131b with respect to attachment part 133a and 133b.

The first knot 66a and the second knot 66b can be along auxiliary strand 33 spaced apart fixed range L, make that gap 24c is maintained engagement state when anchor log main body 22a and 22b are inserted into corresponding target anatomical position 24a and 24b.For example, will tie before 66a and 66b inject corresponding target anatomical position 24a and 24b, gap 24c can be engagement state.During operation, in case implant the first anchor log 22a and the second anchor log 22b at the corresponding first target anatomical position 24a and the second target anatomical position 24b place, knot 66a-b just can be in unlocked configurations, like this, to corresponding actuating strand 38a-b(actuation part 131a-b for example) apply actuation force F and just make corresponding anchor log main body 28a-b be actuated to expanded configuration from first configuration.Then, the stretching latching force can be applied to against the respective attachment part 133a-b of the knot 66a-b of correspondence, be actuated to its locked configuration and anchor log 22a-b is maintained its expanded configuration in order to will tie 66a-b.

The first knot 66a and second ties that distance L between the 66b can be substantially equal to or less than the distance between target anatomical position 24a and the 24b, the feasible first anchor log 22a of working as and the second anchor log 22b expand at the dissection rear and are engaged by auxiliary strand 33 binding time crack 24c, thereby the tension force that produces among feasible actuating strand 38a and the 38b is kept the joint of gap 24c.Although the first connector members 63a and the second connector members 63b can be configured to corresponding knot 66, but be to be understood that, among the first connector members 63a and the second connector members 63b any one or both can or be configured to any suitable locking component 63 of any kind as herein described, or any suitable alternative mode of employing locking component of constructing.For example, among the connector members 63a-b at least one or both can limit joint, thus, the corresponding strand 38a-b that activates can be by activating another person among the strand 38a-b or itself being engaged, and after activating anchor log 22a and 22b, the adapter strand is arranged under the tension force, to apply the compression stress that prevents anchor log strand 38a-b translation.

Should be appreciated that anchor log main body 28a and 28b can construct according to required any suitable embodiment.For example, referring now to Fig. 1 G-1H, each among anchor log main body 28a and the 28b can comprise from the eyelet 90 of the remote extension of corresponding expandable part 36a and 36b.Activate strand 38 and can be configured to the auxiliary strand 33 that separates with anchor log main body 28.The actuating strand can pass anchor log main body 28a and 28b weaves, and extensible corresponding eyelet 90a and the 90b of passing, be used for when anchor log main body 28a and 28b are actuated to expanded configuration from first configuration, limit eyelet 90a and 90b and pass the path that corresponding anchor log main body 28a and 28b advance.Therefore auxiliary strand 33 can be attached to the second anchor log main body 28b with the first anchor log main body 28a, and can be configured to receive actuation force F, described actuation force F makes anchor log main body 28a and 28b in case at corresponding target anatomical position 24a with 24b is implanted just is actuated to expanded configuration from first configuration.

As mentioned above, anchor log assembly 20 can comprise any suitable connector members 63, described connector members 63 can be configured to be attached to the first actuation part 131a and the second actuation part 131b, be attached to one another thereby make the first actuating strand 38a and second activate strand 38b, and anchor log 22a and 22b are attached to one another.The first actuating strand 38a and the second actuating strand 38b are depicted as integrally with each other, thus and restriction common actuation strand.Alternatively, first activate strand 38a and second activate strand 38b can be separated from one another and be attached to one another in the mode of any needs.

According to the embodiment shown in Fig. 1 G-H, connector members 63 activates strand 38a by first and the second actuating strand 38b limits, and in aggregates with the first actuating strand 38a and the second actuating strand 38b.Therefore, actuation part 131a and the 131b of actuating strand 38a and 38b are directly attached each other.Connector members 63 can limit sliding component 47 and locking component 64 at contact 125 places.For example, connector members 63 can limit knot 66, and described knot 66 can be constructed as required, and can be limited by the one or both that activates among strand 38a and the 38b.Therefore, at least a portion of connector members 63 can be in aggregates with at least one or both that activate among strand 38a and the 38b.

First activates strand 38a and second activates the rear end 68 that one among the strand 38b can limit knot 66, and another person among the first actuating strand 38a and the second actuating strand 38b can limit the free end 70 of knot 66.In accordance with the embodiments illustrated, first activate strand for example the first actuation part 131a limit rear end 68, and second activate strand 38b for example the second actuation part 131b limit free end 70.

Thereby tension force is applied to activate strand 38a and 38b make the first anchor log 22a and the second anchor log 22b towards offset with respect to each and joint clearance 24c before, first activates strand 38a and second activates strand 38b and can tie up and be tied in a knot 66.In case form knot 66, and when knot 66 is in unlocked configurations, actuation force F can be applied to and activates strand 38a and 38b, be applied to actuation part 131a-b particularly, in order to make corresponding expandable part 36 be actuated to expanded configuration from first configuration.Next, engaging force AF can be applied to and define first of back strand 68 and activate the terminal part 135a of strand 38a, thus make rear end 68 slide through knot 66 and towards another anchor log for example the second anchor log 22b spur for example first anchor log 22a of corresponding anchor log.In case gap 24c engages, for example the free strand 70b of the free end 70 that is limited by the second terminal part 135b that activates strand 38b just can place under the tension force, so that locking knot 66 also prevents that first activates strand 38a and translate across knot 66, thereby will activate strand 38a and 38b is fixed under the tension force.Although connector members 63 can be configured to tie 66, should be appreciated that connector members 63 can or according to any embodiment as herein described or be configured with any suitable alternative adapter as required.

Referring now to Fig. 2 A-C,, and roughly describe with respect to Figure 1A-B as mentioned, anchor log assembly 20 can comprise the first anchor log 22a and the second anchor log 22b.The first anchor log 22a comprises the first anchor log main body 28a, and this first anchor log main body is extended along prolonging direction 34 basically, and limits more than first the opening 40a that extends through the first anchor log main body 28a.The first anchor log 22a comprises that also first activates strand 38a, this first actuating strand extends through at least one among the opening 40a, a plurality of openings for example, and be configured to receive the actuation force F that makes the first anchor log main body 28a be actuated to expanded configuration from first configuration in described mode above.First activates strand 38a can separate and be attached to the first anchor log main body 28a with the first anchor log main body 28a, the opening that for example passes the first anchor log main body 28a weaves, or can be with the first anchor log main body 28a in aggregates and extend through the opening of the first anchor log main body 28a.

The second anchor log 22b comprises the second anchor log main body 28b, and this second anchor log main body is extended and limited more than second the opening 40b that extends through the second anchor log main body 28b along prolonging direction 34 basically.The second anchor log 22b comprises that also second activates strand 38b, this second activates strand and extends through for example a plurality of openings of opening 40b() at least one, and be configured to receive the actuation force F that makes the second anchor log main body 28b be actuated to expanded configuration from first configuration in described mode above.Second activates strand 38b can separate and be attached to the second anchor log main body 28b with the second anchor log main body 28b, the opening that for example passes the second anchor log main body 28b weaves, and is perhaps can be with the second anchor log main body 28b in aggregates and extend through the opening of the second anchor log main body 28b.

According to the embodiment shown in Fig. 2 A-B, it is in aggregates that the first actuating strand 38a and second activates strand 38b and the corresponding first anchor log main body 28a and the second anchor log main body 28b.According to other embodiment, first activates strand 38a and second activates strand 38b and is depicted as and separates with the second anchor log main body 28b with the corresponding first anchor log main body 28a and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b.According to other embodiment, first activates strand 38a and second, and to activate one among the strand 38b in aggregates with corresponding anchor log main body, and first activate strand 38a and second activate among the strand 38b another person and corresponding anchor log body portion from and be attached to corresponding anchor log main body.Activating strand 38a and second according to first activates strand 38b and is illustrated and is described as the embodiment in aggregates with the corresponding first anchor log main body 28a and the second anchor log main body 28b, be to be understood that, except as otherwise noted, otherwise first activate strand 38a and second and activate strand 38b and can or separate with the second anchor log main body 28b with the corresponding first anchor log main body 28a and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b.In addition, activate strand 38a according to first and activate the embodiment that strand 38b is illustrated and is described as to separate and be attached to the corresponding first anchor log main body 28a and the second anchor log main body 28b the corresponding first anchor log main body 28a and the second anchor log main body 28b with second, be to be understood that, except as otherwise noted, otherwise first activate strand 38a and second activate strand 38b can or in aggregates with the corresponding first anchor log main body 28a and the second anchor log main body 28b.

Continuation is referring to Fig. 2 C, anchor log assembly 20 can comprise at least one connector members 63, described at least one connector members is configured to connect anchor log 22, and allow bias force is applied among anchor log 22a and the 22b at least one so that anchor log 22a and 22b are moved to together, dissect damaged 24 thereby engage.Connector members 63 can with the first anchor log 22a and the second anchor log 22b in one or both in aggregates, for example in aggregates with first one or both that activates among strand 38a and the second actuating strand 38b, can with the first anchor log main body and the second anchor log main body in one or both in aggregates, perhaps can separate with the one or both among the second anchor log 22b with the first anchor log 22a and (directly or indirectly) is attached to one or both among the first anchor log 22a and the second anchor log 22b.For example, as describing in more detail hereinafter, connector members 63 can separate with the first anchor log 22a and the second anchor log 22b and be attached between the first anchor log 22a and the second anchor log 22b.Although connector members 63 is described according to each embodiment as this paper, should be appreciated that anchor log assembly 20 can or comprise any suitable connector members that is configured to the first anchor log 22a is attached to the second anchor log 22b.At least one or both that activate among the strand 38a-b can be configured to receive engaging force AF, this engaging force make among the first anchor log 22a and the second anchor log 22b at least one towards another person's biasing so that joint clearance 24c.

Anchor log assembly 20 can comprise the connector members 63 in aggregates with corresponding actuating strand 38a and 38b.As mentioned above, the corresponding first target anatomical position 24a and the second target anatomical position 24b place that each among the first anchor log main body 28a and the second anchor log main body 28b can be on the opposite side that is arranged at the gap 24c shown in Fig. 2 A is implanted.First activates strand 38a and second activates among the strand 38b each and can receive basically actuation force F along prolonging direction 34, this actuation force makes the corresponding first anchor log main body 28a and the second anchor log main body 28b, be in particular corresponding expandable part 36a and 36b, be actuated to expanded configuration from first configuration, in order to the first anchor log main body 28a and the second anchor log main body 28b are fixed on the corresponding first target anatomical position 24a and the second target anatomical position 24b place.Be applied to first and activate strand 38a and second and activate the form that each actuation force F among the strand 38b can be different actuation forces, perhaps as described in greater detail belowly can be identical actuation force.

Referring now to Fig. 2 B,, in case the first anchor log main body 28a and the second anchor log main body 28b are fixed to the corresponding first target anatomical position 24a and the second target anatomical position 24b, engaging force AF just can be basically be applied to first along the direction of another person in the corresponding first anchor log main body 28a and the second anchor log main body 28b and activates section 38a and second and activate at least one or both among the section 38b, and described direction also can be towards corresponding gap 24c.Therefore, engaging force AF can have vector, and described vector another person in the corresponding first anchor log main body 28a and the second anchor log main body 28b for example can merely point to another person among the first anchor log main body 28a and the second anchor log main body 28b.Equally, engaging force AF can have point to gap 24c(and for example merely point to gap 24c) vector.Therefore, engaging force AF makes at least one or another persons in anchor log main body 28a and 28b among anchor log main body 28a and the 28b bias to corresponding offset position with joint clearance 24c.

Refer again to Fig. 2 C, can limit the connector members 63 of at least one or both in sliding component 47 and the locking component 64, for example at contact 125 places first adapter activated strand 38a and second adapter and activate strand 38b and be attached at together.Therefore, should be appreciated that in sliding component 47 and the locking component 64 at least one can be equally activates strand 38a with first and be attached to second and activate strand 38b.According to an embodiment, connector members 63 can activate strand 38a and second first and activate strand 38b and attached first activate strand 38a and the second actuating strand 38b after being under the tension force, so that gap 24c is maintained engagement state.Member 63 is actuatable to locked configuration, to prevent or resistance can make gap 24c separating from the open first anchor log 22a of engagement state and the second anchor log 22b.Alternatively or in addition, connector members 63 can activate strand 38a and 38b and will activate strand 38a and before 38b places under the tension force in that engaging force AF is applied to, therefore and before the 24c of joint clearance, make first to activate strand 38a and second and activate strand 38b and be attached to one another.

According to some embodiment, connector members 63 is limited by the first actuating strand 38a and the second actuating strand 38b and is in aggregates with the first actuating strand 38a and the second actuating strand 38b, and can be configured to can be between unlocked configurations and locked configuration repeatedly slip and locking knot, pass through unlocked configurations, activating one among strand 38a and the 38b can slide with joint clearance 24c with respect to another person, and prevents from activating strand 38a and 38b relative to each other slides through knot by locked configuration.Connector members 63 limits at least one in sliding component 47 and the locking component 64 at contact 125 places.Therefore we can say that connector members 63 can activate strand 38a with first directly or indirectly and the second actuating strand 38b is attached at together.

Referring now to Fig. 3 A,, fixation kit 250 can comprise anchor log assembly 20, and at least one anchor log 22 for example, and insert apparatus 252, this insertion apparatus are configured to anchor log 22 is injected in the anatomical structure 24 as shown in Figure 1A-B.Should be appreciated that fixed sleeve part 250 can comprise at least one anchor log 22 or more and even all anchor logs 22 that this paper describes separately, described anchor log is attached to one another, or is configured to be attached to one another according to any embodiment described herein.Inserting apparatus 252 can comprise intubate 254 with central opening 256 and first pusher member for example plunger or push rod 25, the first pusher member can coaxial insertion central openings 256.Intubate 254 has pointed tip 260 and from most advanced and sophisticated 260 axially extended slits 268.Intubate 254 straight extension basically as shown in the figure, or can be crooked, or limit any suitable shape as required in order to eject anchor log main body 28.

In addition, insert apparatus 252 and comprise the shank 262 with action bars 264.One end of shank 262 removably is attached to intubate 254, and action bars 264 removably is attached to plunger 258.The external diameter of plunger 258 is corresponding to the internal diameter of the central opening 256 of intubate 254.In rear end, the central opening of intubate 254 disposes towards the mode that the rear end of intubate 254 enlarges at entrance 266 places conically with described central opening.Therefore, the anchor log main body 28 of anchor log 22 can its first configuration be inserted and is entered the central opening 256 of intubate 254 by conical entrance 266, makes that anchor log main body 28 can be compressed.

When extruding from intubate 254 by plunger depressed 258 forward and with anchor log main body 28, anchor log main body 28 can be for example along second direction 35(referring to Figure 1A-B) expanded radially, the mode that adopts is to activate on the strand 38 when tightening anchor log main body 28 when tension force is applied to, and anchor log main body 28 can be by the front surface maintenance of intubate 254.Guiding activates strand 38 and passes slit 268, makes when intubate 254 is inserted into anatomical structure 24, can activate strand 38 in the guiding of the next door of intubate 254.At the attached pin 270 of free end that activates strand 38, when the anchor log main body 28 of anchor log 22 had been actuated to expanded configuration and has been fixed to anatomical structure 24, pin 270 can be used for finishing surgical operation.

Referring to Fig. 3 B, plunger 258 can have external diameter or optional cross sectional dimensions, and this external diameter or optional cross sectional dimensions are less than internal diameter or the cross sectional dimensions of the central opening 256 of intubate 254.Therefore, when plunger 258 inserted the central opening 256 of intubate 254, the actuating strand 38 of anchor log 22 can be guided through the central opening 256 of intubate 254.By activate action bars 264 at shank 262 places, plunger 258 can promote anchor log 22 forward in intubate 254, leave from central opening 256 at 260 places, tip of intubate 254 up to anchor log main body 28.In case anchor log main body 28 is positioned in the central opening 256, just can the rear end of intubate 254 backward tractive activate strand 38, make anchor log main body 28 can in chamber 256, be actuated to its expanded configuration.

Referring to Fig. 4 A-D, plunger 258 can limit central bore 272, and the actuating strand 38 of bootable anchor log 22 passes central bore 272.In addition, intubate 254 has first vertical hole 274 of extending between the tip 260 of intubate 254 and rear end, make intubate 254 slotted on its whole length.Is extending between the front-end and back-end of plunger 258 on the plunger 258 in second vertical hole 276, makes plunger 258 also slotted on its whole length.Shown in Fig. 4 B, when intubate 254 was in first position of rotation with respect to plunger 258, first vertical hole 274 of intubate 254 was relative on diameter with second vertical hole 276 of plunger 258.At first position of rotation of intubate 254, the actuating strand 38 of anchor log 22 is kept by central bore 272.In case by the actuating strand 38 of tractive anchor log 22 backward the anchor log main body 28 of anchor log 22 is fixed in patient's the body cavity, just intubate 254 can be rotated to second position of rotation (Fig. 4 D) with respect to plunger 258.At this second position of rotation of intubate 254, align with second vertical hole 276 of plunger 258 in first vertical hole 274 of intubate 254, and insertion apparatus 252 can discharge from the actuating strand 38 of anchor log 22.

Fig. 5 A-D shows shank 262, and the shank 262 of the embodiment of the insertion apparatus 252 of intubate 254 to Fig. 3 A to Fig. 4 D is attached.The upper part of shank 262 comprises spring member for example sheet spring 279 and the groove 278 that can insert intubate 254, but in order to provides the retracting spring lock that is configured to intubate 254 is attached to releasedly shank 262.The rear end of plunger 258 can buckle into the elasticity fork 280 of the upper end that is arranged in action bars 264.

Referring to Fig. 6, insert apparatus 52 and can be included in degree of depth control valve 282 and the clamping element 284 that slides in intubate 254 tops.Come to carry out preparing before the art to inserting apparatus 52 by the mode of anchor log 22 being inserted intubate 254 and insertion plunger 258.In case anchor log 22 and plunger 258 have inserted, just by the mode on the rear portion that first contact pin 286 is snapped onto intubate 254, make in a plurality of clamping elements 284 any be attached to the rear end of inserting apparatus 252.For preventing plunger 258 with respect to intubate 254 displacement that meets accident, clamping element 284 comprises in abutting connection with second contact pin 288 of the rear end of intubate 254 and in abutting connection with the 3rd contact pin 290 of the amplifier section of the rear end of plunger 258.Before using insertion apparatus 252, remove clamping element 284 and shank 262 is attached to intubate 254 from intubate 254, and can mode described herein operate insertion apparatus 252.

Referring now to Figure 1A and Fig. 7 A-D,, the insertion apparatus 300 of constructing according to alternative embodiment is configured to that for example first anchor log knot 22a and second anchor log knot 22b are delivered to corresponding target location for example target location 24a and 24b(Figure 1A with at least one anchor log knot).Insert apparatus 300 be shown as longitudinally axis 302(its basically longitudinally L extend) elongation, and limit near-end 304 and longitudinally axis 302 and near-end 304 isolated relative far-ends 306.Therefore, should be appreciated that term " distally " and " nearside " and derivative words thereof refer to the dimensional orientation of more close far-end 306 and near-end 304 respectively.In addition, direction term " downstream " and " upstream " and derivative words thereof refer to 306 directions of extending from near-end 304 towards far-end respectively, and the directions of 304 extensions from far-end 306 towards near-end.Insert apparatus 300 and also be substantially perpendicular to the side direction A of vertical L in the edge, and the horizontal T extension that is substantially perpendicular to vertical L and side direction A.We can say that also side direction A and horizontal T radially extend with respect to longitudinal axis 302.Therefore, term " radially outward " and " radially inside " and derivative words thereof refer to respectively away from direction towards longitudinal axis 302, and can be as required with side direction with laterally use with the free burial ground for the destitute.

Insert apparatus 300 and comprise housing 308 and intubate 310, housing 308 can provide shank, and intubate 310 is supported by housing 308 and 308 distad extends out along central axis 309 from housing.Intubate 310 can be fixed to housing 308 with respect to translation.But central axis 309 longitudinal extensions and therefore can with the longitudinal axis 302 that inserts apparatus 300 in line, or can be with respect to longitudinal axis 302 skews of inserting apparatus 300.Intubate 310 is straight extension basically as shown in the figure, but itself or can be crooked or limit any suitable alternative shape as required.Intubate 310 limits elongated open 312, this elongated open can be elongated or be elongate along any other direction of expectation or the combination of direction in the vertical, and its size is configured to hold at least one anchor log knot for example first anchor log knot 22a and second anchor log knot 22b.Insert apparatus 300 and can comprise that also the biasing member that is arranged in the elongated open 312 for example fills in 314, making wins ties the upstream position that anchor log main body 28a is arranged on the plug 314 in the intubate 310, and the second knot anchor log 28b is arranged on the downstream position of the plug 314 in the intubate 310.Therefore, plug 314 also can provide the spacer that the first anchor log main body 28a is longitudinally separated with the second anchor log main body 28b.The first anchor log main body 28a and the second anchor log main body 28b longitudinally axis 302 are stacked in the apparatus 300.Intubate 310 limits distal tip 311, and this distal tip is configured in the target location piercing tissue so that at least one anchor log is delivered to the target location.

Insert apparatus 300 and also can comprise the plunger 316 that supports and extend out from housing 308 towards nearside by housing 308.Plunger 316 is configured to distad move to the second position shown in Fig. 8 A-D from the initial or primary importance shown in Fig. 7 A-D along first stroke, thereby make the plug 314 second anchor log 22b that distad setover, so that the second anchor log 22b is ejected from intubate 310, for example pass most advanced and sophisticated 311 distally from longitudinal extension basically and eject port 442 and eject.

In case the second anchor log 22b ejects from ejecting port 442, plunger 316 just is configured to along the first of second stroke shown in Figure 11 A-C and along the further distad translation of second portion of second stroke shown in Figure 12 A-C, make that push rod 330(is referring to Fig. 7 C) the first anchor log main body 28a that distad setovers so that the first anchor log 22a from intubate 310(for example from ejecting port 442) eject and enter the first target anatomical position 22a.Alternatively, as described in greater detail below, it is hereinafter described in conjunction with Figure 31 that intubate 310 can limit side ejection port 318(), this side ejects port and is configured to along the direction that is offset with respect to central axis 309 angledly the first anchor log main body 28a and the second anchor log main body 28b be ejected from intubate 310.

Insert apparatus 300 and can be configured to make plunger 316 before moving to the centre position shown in Figure 10 A-D along mid-stroke from deviation post, from second position distal motion to the deviation post shown in Fig. 9 A-D.Therefore, plunger 316 can move to deviation post from the second position, again to the centre position, and final to the 3rd position shown in Figure 12 A-D.In accordance with the embodiments illustrated, plunger 316 rotated to the centre position from the second position before moving to the 3rd position along second stroke.For example, the first along second stroke shown in Figure 11 A-D before plunger 316 can move at the second portion along second stroke shown in Figure 12 A-D moves.Can after ejecting actuation force be applied to actuation part 131a and the 131b of the first anchor log 22a and the second anchor log 22b at each anchor log respectively, perhaps can be used as another and be chosen in anchor log 22a and 22b and all ejected and applied afterwards actuation force. Anchor log 22a and 22b can for example be attached to one another across gap 24c as required by any way.

Referring now to Fig. 7 A-C,, particularly, housing 308 limits main body 320, and at least one lateral wall 322 radially of this main part limitation for example can be a plurality of walls that are connected of virtually any size and shape, and limits proximal wall 324 and relative distal wall 326.Described at least one outer wall 322, proximal wall 324 and distal wall 326 limit the inside 328 that can be communicated with elongated open 312 fluids of intubate 310 at least in part.Intubate 310 is attached to the distal wall 326 of housing 308 and therefore is fixed to housing 308.Intubate 310 distad extends to most advanced and sophisticated 311 from housing 308.Tip 311 is convergent distad, makes intubate 310 limit the far-end of tapers.For example, tip 311 can be conical, that is, tip 311 can limit and be a conical part, and can limit cone shape or limit any suitable alternative shape as required.Insert apparatus 300 and also can comprise supporting sleeve 313, this supporting sleeve surrounds intubate 310 at least in part at the seam with housing 308, and distad extends along the part of intubate 310 length.Supporting sleeve 313 provides support structure and rigidity for intubate 310.

Plunger 316 limits the far-end 316a that is arranged in inner 328, extends and from the proximal wall 324 extended main part 316b of housing 308 from far-end 316a proximad, and the near-end 316c that can limit the grasping part that is arranged on housing 308 outsides.Insert apparatus 300 and also comprise the first pusher assembly 317, this first pusher assembly can comprise plunger 316 and first pusher member, for example directly or indirectly is attached to the push rod 330 of the far-end 316a of plunger 316.It is for example in aggregates with plunger 316 that push rod 330 can be attached to plunger 316(, or be attached to plunger 316 discretely via required any suitable fasteners or intermediate equipment).For example, in accordance with the embodiments illustrated, the far-end 316a of plunger is attached to the maintenance shell of describing in more detail in conjunction with Figure 17 as hereinafter 392.Push rod 330 is attached to and keeps shell 392, and therefore is attached to plunger 316.Push rod 330 can distad extend into the opening 312 of intubate 310 and the distal wall 326 of extending housing 308 from plunger 316.Should be appreciated that reference at least one or both in plunger 316 and the push rod 330 is applicable to the first pusher assembly 317.For example, can be said to about description fixing or that be attached to the structure of at least one or both in plunger 316 and the push rod 330 is to fix or be attached to the first pusher assembly 317 respectively.

But because push rod 330 translations be fixed to plunger 316, so the motion in plunger 316 proximads and distally will make push rod 330 same proximad and distal motion.The far-end 330a that push rod 330 limits in the opening 312 that is arranged on intubate 310.Therefore, the far-end 330a of push rod 330 is configured to when inserting apparatus 300 and be positioned at primary importance shown in Fig. 7 A-D against the first anchor log 22a.The far-end 330a of push rod 330 is configured to when insertion apparatus 300 is in primary importance, and when plunger 316 and and then push rod 330 when distad moving to the second position from primary importance against the first anchor log 22a, make push rod 330 that the first anchor log 22a is ejected and enter corresponding target location 24a from inserting apparatus 300.When having been ejected at the first anchor log main body 28a and after anatomical structure 24, and when tension force being applied to corresponding actuation member 37a along the prolonging direction of anchor log main body 28a basically, anchor log main body 28a expands (referring to for example Figure 1A-B) along the prolonging direction 34 vertical second directions 35 with respect to anchor log main body 28a.

Insert apparatus 300 and also can comprise the second pusher assembly 333, this second pusher assembly comprises attachment members 331, for example extend and surround at least in part the collar 332 of plunger 316 around plunger 316, and second pusher member, for example distad extend and surround at least in part the ejector sleeve 334 of push rod 330 from collar 332.It is for example in aggregates with collar 332 that ejector sleeve 334 can be attached to collar 332(, or be attached to collar 332 discretely via required any suitable fasteners).Therefore, to the description of at least one or both in ejector sleeve and the collar 332 applicable to the second pusher assembly 333.For example, can be said to about description fixing or that be attached in ejector sleeve 334 and the collar 332 at least one or boths' structure is to fix or be attached to the second pusher assembly 333 respectively.

Ejector sleeve 334 can comprise plug 314, and it can limit the far-end of ejector sleeve 334.Ejector sleeve 334 can be hollow in accordance with the embodiments illustrated, in order to limit elongated in the vertical opening 335, and push rod 330 has the external diameter less than opening 335 external diameters, makes push rod 330 be arranged in the elongated open 335 of ejector sleeve 334.Should be appreciated that structure that this paper is described as limiting diameter can or limit the cross section of any suitable configuration, this cross section can be circular or alternative shape, and therefore can limit and can be any cross sectional dimensions of diameter or non-diameter.Intubate 310 can be held the first anchor log main body 28a and the second anchor log main body 28b.For example, ejector sleeve 334 can hold the first anchor log main body 28a at plug 314 upstream position, and intubate 310 can be in the position in plug 314 distally, and and then holds the second anchor log main body 28b in the position in the first anchor log main body 28a distally.

Insert apparatus 300 and can comprise the force transmitting member 336 that can extend internally from the distal radial of collar 332, make push rod 330 distad extend through force transmitting member 336 or distad extend from force transmitting member 336.Force transmitting member 336 can maybe can be fixed to the far-end of collar 332 in abutting connection with collar 332.Force transmitting member 336 also can in abutting connection with or be fixed to the near-end of ejector sleeve 334.If the one or both of force transmitting member 336 in collar 332 and the ejector sleeve 334, then 1) distal movement of collar 332 will make force transmitting member 336 distad setover, then make ejector sleeve 334, comprising distad biasing of plug 314, and 2) proximal movement of collar 332 do not make the biasing of ejector sleeve 334 proximads.If force transmitting member 336 is attached to collar 332 and ejector sleeve 334, then 1) distal movement of collar 332 will make force transmitting member 336 distad setover, then make ejector sleeve 334, comprise distad biasing of plug 314, and 2) proximal movement of collar 332 will make force transmitting member 336 distad setover, then make ejector sleeve 334, comprise distad biasing of plug 314.No matter force transmitting member 336 be in abutting connection with or be fixed to collar 332 and ejector sleeve 334, we can say, but collar 332 translations be attached to ejector sleeve 334, make the distally translation of collar 332 cause distad translation of ejector sleeve 334.

Collar 332 and and then ejector sleeve 334, comprise plug 314, be configured to selectively be attached to the first pusher assembly 317 and break away from the first pusher assembly 317 with respect to translation, and be configured to selectively be attached to housing 308 and break away from housing 308 with respect to translation.For example, under first configuration, but collar 332 translations be fixed to plunger 316, and therefore also be fixed to push rod 330.In addition, under first configuration, but collar 332 translations ground and housing 308 disengagings, but and therefore also break away from intubate 310 to translation.Therefore, under first configuration, plunger 316 and push rod 330 make collar 332 with respect to housing 308 and intubate 310 proximad and distal motion accordingly with respect to the proximal movement of housing 308 and intubate 310 and distal movement.Be to be understood that, under first configuration, but push rod 330 translations be attached to ejector sleeve 334, make for example translation in tandem during first stroke of push rod 330 and ejector sleeve 334, thereby ejector sleeve 334 is ejected the second anchor log main body 28b from intubate 310, as hereinafter describing in more detail.As mentioned above, when after ejecting the second anchor log main body 28b and basically tension force being applied to corresponding actuation member 37b along the prolonging direction of the second anchor log main body 28b, the second anchor log main body 28b expands (referring to for example Figure 1A-B) along the prolonging direction 34 vertical second directions 35 with respect to anchor log main body 28b.

Under second configuration, but collar 332 translations ground break away from plunger 316 and therefore break away from push rod 330, but and translation ground be attached to housing 308 and so be attached to intubate 310.Therefore, under second configuration, plunger 316 and push rod 330 are with respect to collar 332 and housing 308 and intubate 310 proximads and distal motion.Be to be understood that, under second configuration, after first stroke, but push rod 330 translations ground breaks away from ejector sleeve 334, make push rod 330 for example during at least a portion of second stroke, with respect to ejector sleeve 334 and and then with respect to plug 314 distad translations, thereby push rod 330 is ejected the first anchor log main body 28a from intubate 310, as describing in more detail hereinafter.

Referring now to Figure 13 A-G,, insert apparatus 300 and comprise guidance system 329, this guidance system is coupling housing 308 and ejector sleeve 334 operationally, in order to the relative motion between housing 308 and the push rod 330 is led.In accordance with the embodiments illustrated, guidance system 329 comprises first ways 338 and second ways 340 of the complementation that is connected in respectively between housing 308 and the collar 332.In accordance with the embodiments illustrated, during the first and first stroke of second stroke, first ways 338 and second ways 340 cooperate to guide plunger 316(and push rod 330) and collar 332(and ejector sleeve 334) move in tandem with respect to housing 308.In this, should be appreciated that first ways 338 and second ways 340 operationally are connected between plunger 316 and the collar 332 during the first of second stroke and first stroke.In accordance with the embodiments illustrated, during the second portion of second stroke, first ways 338 and second ways 340 cooperate to guide plunger 316 and push rod 330 with respect to collar 332(and ejector sleeve 334) and housing 308 the two motions.In this, should be appreciated that first ways 338 and second ways 340 operationally are being connected in during the second portion of second stroke between housing 308 and the collar 332.

In accordance with the embodiments illustrated, in first ways 338 and second ways 340 one can be provided as extending into the guide rail 342 of one in collar 332 and the housing 308, and another person in first ways 338 and second ways 340 can be provided as extending into the pilot pin 344 of guide rail 342, make pilot pin 344 take in guide rail 342, thereby make collar 332 operationally be attached to housing 308.In accordance with the embodiments illustrated, first ways 338 is provided as by collar 332 carrying and the guide rail 342 that limits, but and second ways 340 is fixed to housing 308 with being provided as translation and extend into the pilot pin 344 of guide rail 342.For example, pilot pin 344 radially extends into or passes the sidewall 322 of housing 308, enters guide rail 342 then.Should be appreciated that according to alternative embodiment guide rail 342 can and limit by housing 308 carrying, but and pilot pin 344 can be fixed to translation collar 332.

According to the embodiment shown in Figure 13 G, track 342 limits the slit 339 that radially extends into collar 332 but do not pass collar 332, and the base portion 341 of collar 332 that is positioned at the radial inner end place of slit 339.Guide rail 342 limits first targeting parts (for example first rail portion 342a), with respect to the first rail portion 342a, second targeting part of radial offset (for example second rail portion 342b) for example, and the first rail portion 342a is connected to targeting part (for example angled intermediate orbit part 342c) in the middle of the second rail portion 342b angled.Therefore, pilot pin 344 is configured to advance along the first rail portion 342a plunger 316 moves to first stroke of the second position from primary importance during.Particularly, the second rail portion 342b limits first or far-end 342a ', relative second or near-end 342a ' ', and is positioned at the deviation post 342a ' ' ' between far-end 342a and the near-end 342a ' '.Deviation post 342a ' ' ' with align at the intermediate orbit part 342c that extends between the first rail portion 342a and the second rail portion 342b.In case pilot pin 344 moves to deviation post 342a ' ' ' from near-end 342a ' ', then when plunger 316 rotated to the centre position, pilot pin 344 can be advanced towards the second rail portion 342b along intermediate orbit part 342c.Pilot pin 344 can distad be advanced along the second rail portion 342b during towards the further translation in the 3rd position at plunger 316 subsequently.

The first rail sections 342a and the second rail sections 342b be longitudinal extension basically, makes collar 332 distally translation with respect to housing 308 during first stroke cause pilot pin 344 and relative to each other translation of guide rail 342.According to the embodiment as shown in Figure 13 A-B, guide rail 342 is with respect to distad translation of pilot pin 344, thus make pilot pin 344 during first stroke of plunger 316 and collar 332 along the first rail sections 342a proximad translation.In case finish first stroke and ejected the second anchor log main body 28b from intubate 310, the near-end 342a ' ' that pilot pin 344 just is arranged on the first rail portion 342a locates.Collar 332 limits the stop dog component of the proximal end of the first rail portion 342a.Therefore, pilot pin 344 disturbs collar 332, thereby prevents that plunger 316 and collar 332 are with respect to distad further translation of housing 308.Therefore, prevent that user from ejecting the first anchor log main body 308a unintentionally by the continuation distally translation of plunger 316 after the second anchor log main body 28b has ejected.

Should be appreciated that during first stroke pilot pin 344 moves to near-end 342a ' ' (shown in Figure 13 B) from distal part 342a ' (shown in Figure 13 A) through deviation post 342a ' ' ' (shown in Figure 13 C).When pilot pin 344 was in deviation post 342a ' ' ', ejector sleeve 344 ejected port 442 proximads cave in a little (referring to Fig. 9 D) with respect to the distally.When pilot pin 344 moved to near-end 342a ' ', ejector sleeve 344 was with respect to ejecting distad translation of port 442 (referring to Fig. 8 D).As Fig. 8 A and Fig. 9 A further shown in, insert apparatus 300 and comprise the spring member 365 that can be wind spring, this spring member 365 for example is fixed on distal wall 326 places of housing 308 being fixed to housing 308() spring base 381 and force transmitting member 336 between extension.Therefore, spring member 365 operationally is connected between housing 308 and the second pusher assembly 333.When the second pusher assembly 333 was attached to the first pusher assembly 317 with respect to translation, spring member 365 operationally was connected between housing 308 and the first pusher assembly 317.

Spring member 365 distad provides collar 332 and and then the power of plunger 316 proximads biasing of making at plunger 316 during translation along first stroke.Therefore, referring to Figure 13 B-C, in case pilot pin 344 is in the second position that the near-end 342a ' ' of the first rail portion 342a locates, spring force just makes collar 332 bias movement, make pilot pin 344 from the near-end 342a ' ' of the first rail portion 342a distad towards the far-end 342a ' translation of the first rail portion 342a.Yet as described in more detail below, track 342 comprises base portion 341, and this base portion disturbs pilot pin 344 from deviation post 342a ' ' ' moving along distal direction.When pilot pin 344 is in deviation post 342a ' ' ', the plug 314 of ejector sleeve 334 ejects port 442 proximads depression or ejects port 442 substantial alignment (referring to Fig. 9 D) with the distally with respect to the distally, makes plug 314 can distad not extend beyond the distally and ejects port 442.

Referring now to Figure 13 C-D,, plunger 316 can rotate along direction of arrow A when advancing along mid-stroke.Insert apparatus 300 and limit the key 318 that rotatably connects plunger 316 and collar 332.In accordance with the embodiments illustrated, key 318 is provided as and prevents that plunger 316 is with respect to the plunger 316 of collar 332 rotations and the complementary flat surfaces of collar 332.Therefore, plunger 316 rotates collar 332 along the rotation of direction of arrow A equally along direction of arrow A.Therefore, after finishing first stroke, the rotation of plunger 316 makes pilot pin 344 march to the far-end of the second rail portion 342b along intermediate orbit part 342c along mid-stroke from the first rail portion 342a.Referring now to Figure 13 D-E,, in case pilot pin 344 is arranged among the second rail portion 342b, plunger 316 and collar 332 just make pilot pin 344 with respect to distad translation of housing 308 along the further translation of the first of second stroke, have marched to the near-end of the second rail portion 342b up to pilot pin 344.Collar 332 limits the stop dog component of the proximal end of the second rail portion 342b, and this stop dog component prevents that collar 332 from continuing distal motion with respect to housing 308.We can say that collar 332 limits the stop dog component of the end of the first rail portion 342a and the second rail portion 342b.

Referring now to Figure 13 E-F and as described in greater detail below,, in case pilot pin 344 has marched to the near-end of the second rail portion 342b, plunger 316 just breaks away from collar 332 along the further distally translation of the second portion of second stroke, makes plunger 316 and push rod 330 with respect to collar 332, ejector sleeve 334 and housing 308 translations.Shown in Figure 12 A-C, plunger 316 is configured to during the second portion of second stroke with respect to collar 332 and distad translation of housing 308, up to the far-end 316c of plunger for example at proximal wall 324 places in abutting connection with housing 308, thereby finish second stroke and the second anchor log main body 28b ejected from intubate.

Specifically referring to Figure 13 G, the base portion 341 of track 342 limits the first base portion part 341a, the second base portion part 341b at the second rail portion 342b place at the first rail portion 342a place, and the central base portion part 341c at intermediate orbit part 342c place now.Base portion 341 has the part darker than other parts, make when pilot pin 344 is taken along track, in auditory feedback and the tactile feedback at least one or both can be detected by user, thereby indicate collar 332 and indicate plunger 316 to finish the part of stroke or stroke in some cases.Base portion 341 also can provide and prevent that pilot pin 344 is along the stop part of a part of proximal motion of track 342.For example, first base portion part 341a restriction first or the distally first base portion part 341a ', and second or the nearside first base portion part 341a ' ' darker than the distally first base portion part 341a '.The first base portion part 341a limits the edge 346a that is arranged between the nearside first base portion part 341a ' and the distally first base portion part 341a ' '.Edge 346a can radially extend or the edge has towards the direction extension of the radial component of longitudinal axis 302 extensions.

Pilot pin 344 can limit rear portion 344a and be connected housing 308 and rear portion 344a between spring member 345, and make rear portion 344a setover in the track 342 and against base portion 341.Therefore, when collar 332 and plunger 316 during along first stroke movement and under the situation of pilot pin 344 with respect to the first rail portion 342a proximal motion, the distal part 344b of pilot pin 344 is the first base portion part 341a ' motion along the distally, and crosses edge 346a when pilot pin 344 marches to the distally first base portion part 341a ' '.When pilot pin 344 crosses that edge 346a advances and during by the biasing of the spring force of spring member 345 and against track 341, at least one the conveyed to user in tactile feedback and the auditory feedback, indication plunger 316 and collar 332 have been finished first stroke.The deviation post 342a ' ' ' that edge 346a can be arranged on first rail portion locates, in case make pilot pin 344 march to the near-end 342a ' ' of the first rail portion 342a along the first base portion part 341a, edge 346a prevents that just the power of spring member 365 from making pilot pin 344 with respect to deviation post 342a ' ' ' the proximad translation of the first rail portion 342a.Yet, because pilot pin 344 joining edge 346a, so the bias force of spring member 365 makes pilot pin 344 align with intermediate orbit part 342c, and be in soon along the appropriate location that mid-stroke is moved or rotated.

Continuation is referring to Figure 13 G, and central base portion part 341c limits first or nearside central base portion part 341c ', and second or the distally central base portion part 341c ' ' darker than nearside central base portion part 341c '.Distally central base portion part 341c ' ' can align with the second base portion part 341b.Central base portion part 341c limits the edge 346c that is arranged between nearside central base portion part 341a ' and the distally central base portion part 341a ' '.Alternatively, central base portion part 341c may lack distal part, makes edge 346c be arranged between central base portion part 341c and the second base portion part 341b.Edge 346c can radially extend or the edge has towards the direction extension of the radial component of longitudinal axis 302 extensions.When the distal part 344b of pilot pin 344 when mid-stroke and the transition period between second stroke are crossed that edge 346c advances and are alignd with the second rail portion 342b, at least one conveyed to user in tactile feedback and the auditory feedback, indication plunger 316 and collar 332 have been finished mid-stroke, and are in soon the appropriate location of moving along the first of second stroke.In addition, in case pilot pin 344 is positioned among the second rail portion 342b, edge 346c just prevents plunger 316 edges and direction of arrow A(Figure 13 C) relative direction rotation.

Second base portion part 341b restriction first or the nearside second base portion part 341b ', and second or the distally second base portion part 341b ' ' darker than the nearside second base portion part 341b '.The distally second base portion part 341b ' ' can be arranged on the terminal far-end of the second rail portion 342b.The second base portion part 341b limits the edge 346b that is arranged between the nearside second base portion part 341b ' and the distally second base portion part 341b ' '.Edge 346b can radially extend or the edge has towards the direction extension of the radial component of longitudinal axis 302 extensions.When the distal part 344b of pilot pin 344 crosses edge 346b and advances, at least one the conveyed to user in tactile feedback and the auditory feedback, the first that indication plunger 316 and collar 332 have been finished second stroke.As described in being about to now, this feedback can indicate plunger 316 to break away from collar 332, and can be independent of collar 332 along the second portion translation of second stroke.In addition, in case plunger 316 and collar 332 have broken away from, edge 346b prevents that just pilot pin 344 is along the second rail portion 342b proximal motion.

Referring now to Fig. 7 C and Figure 14 A-D,, insert apparatus 300 and comprise the coupling assembly 350 that is configured between first operator scheme and second operator scheme repeatedly.Under first operator scheme, the translation of coupling assembly 350 during with respect to first stroke, but translation fix first pusher member (being illustrated as push rod 330) and second pusher member (being illustrated as ejector sleeve 334).Under first operator scheme, but coupling assembly 350 can discharge push rod 330 and translation be fixed to ejector sleeve 334, make under second operator scheme, coupling assembly 350 breaks away from push rod 330 and ejector sleeve 334 so that push rod 330 can be after first stroke for example during second stroke with respect to distad translation of ejector sleeve 334.In addition, under second operator scheme, but coupling assembly 350 can with ejector sleeve 334 translations be fixed to housing 308, make the distally translational force that is applied to plunger 316 make plunger 316 and and then push rod 330 with respect to ejector sleeve 334 and and then distad translation of collar 332.In accordance with the embodiments illustrated, coupling assembly 350 is under first operator scheme during the first of second stroke of the mid-stroke of first stroke of the first pusher assembly 317, the first pusher assembly 317 and the first pusher assembly 317.In accordance with the embodiments illustrated, when the first pusher assembly 317 between the second portion of the first of second stroke and second stroke during transition, coupling assembly 350 transits to second operator scheme.In accordance with the embodiments illustrated, when the first pusher assembly 317 during along the second portion translation of the first of second stroke and second stroke, coupling assembly 350 is under second operator scheme.

In accordance with the embodiments illustrated, coupling assembly 350 can comprise at least one first coupling member 352, and described at least one first coupling member is depicted as and radially extends into for example plunger 316 of the first pusher assembly 317() first groove 354.In accordance with the embodiments illustrated, coupling assembly 350 also can comprise at least one second coupling member 356, and described at least one second coupling member is depicted as and radially extends through for example collar 332 of the second pusher assembly 333() passage 358.Coupling assembly 350 also can comprise at least one the 3rd coupling member 360, and described at least one the 3rd coupling member 360 is depicted as second groove 362 by housing 308 carryings.For example, inserting apparatus 300 can comprise by housing 308(for example by the proximal wall 324 of housing 308) inner shell 325 of carrying.In accordance with the embodiments illustrated, second groove 362 extends radially outwardly and enters inner shell 325.Alternatively, second groove 362 can extend radially outwardly and enter housing 308.

In addition, in accordance with the embodiments illustrated, when plunger 316 was in primary importance shown in Fig. 7 C and Figure 14 B, second groove 362 was arranged on the distally with respect to passage 358.When plunger 316 was in primary importance shown in Fig. 7 A and Figure 13 A, second groove 362 also can be with respect to passage 358 radial offset.Alternatively, second groove 362 can be with respect to second groove, 362 radially aligneds (for example, if track 342 does not comprise intermediate orbit part 342c), and also can be annular alternatively, so that as required around the inner radial surface of housing 308.

Coupling assembly 350 also can comprise at least one the tetrad connection member 368 that is depicted as breech lock 370, and the size of breech lock 370 is configured to partly fit in first groove 354 and second groove 362 each.In accordance with the embodiments illustrated, breech lock 370 is by collar 332 carrying, and is configured to be arranged on the sheet spring 371 in the passage 358, and passage 358 can be provided as the perforate of the hole of U-shaped substantially or collar 332 to limit sheet spring 371.The radially inner protuberance 373 of sheet spring 371 carryings, the size of this protuberance is configured to be fitted in first groove of plunger 316.The size of breech lock 370 also can be configured to can be arranged in the passage 358, and is easy to radially inside or outwardly-bent.Therefore, breech lock 370 can be along first groove 354(Figure 14 B) and second groove 362(Figure 14 D) between passage 358 advance.

In accordance with the embodiments illustrated, coupling assembly 350 is under first operator scheme when pilot pin 344 is arranged in the first rail portion 342a, and remain under first operator scheme when the first rail portion 342a marches to intermediate orbit part 342c at pilot pin 344, and still remain under first operator scheme when the part of the second rail portion 342b is advanced at pilot pin 344.Particularly, the protuberance 371 of first groove 354 and passage 358 and breech lock 370 can be positioned, extend into the part of the second rail portion 342b as shown in the figure with convenient pilot pin 344, and first among rail portion 342a and the intermediate orbit part 342c any one or all the time, they are with radially aligned.

Therefore, under first operator scheme, breech lock 370 partly is arranged in first groove 354 of plunger 316, and extends into the passage 358 of collar 332.Can set the size of breech lock protuberance 373, so that it is captured in first groove 354, thereby make plunger 316 be attached to collar 332 with respect to translational motion.Therefore, when breech lock 370 is attached to plunger 316, plunger 316 and collar 332 and and then the first pusher assembly 317 and the second pusher assembly 333 connect with respect to longitudinally motion or translation.

Referring now to Figure 14 C-D,, because in accordance with the embodiments illustrated, the size of second groove 362 is configured to hold breech lock 370, so when breech lock 370 is moved into second groove 362 from first groove 354, breech lock 370 breaks away from the first pusher assembly 317 and the second pusher assembly 333, and make the second pusher assembly 333, be in particular collar 332 with respect to translation at least and be attached to housing 308, and also can make collar 332 be attached to housing 308 with respect to rotation.As mentioned above, housing 308 is with respect to translation at least and be fixed to intubate 310, and can be fixed to intubate 310 with respect to translation.In accordance with the embodiments illustrated, when plunger 316 from second position rotation make to the centre position pilot pin 344 along intermediate orbit part 342c(referring to Figure 13 C-D) when advancing, first groove 354 and passage 358 vertically align with second groove 362.

During the first of second stroke (referring to Figure 13 E), plunger 316 and collar 332 longitudinal translations align with second groove 362 of housing 308 up to first groove 354 and passage 358.Shown in Figure 14 C-D, at first and the transition period between the second portion (also referring to Figure 13 F) of second stroke, breech lock 370 driven (for example cam) goes out first groove 352 and therefore is moved into second groove 362 from first groove 352.According to alternative embodiment, plunger 316 can comprise spring member, and described spring member makes breech lock 370 radially outward setover from first groove 352, enters second groove 362 then.Perhaps, can be arranged so that when second groove 362 of housings 308 is passed through in plunger 316 and collar 332 rotations that breech lock 370 can go out and is moved into second groove 362 from first groove from first groove, 352 cams with inserting apparatus 300.In case breech lock 370 keep with the attached situation of collar 332 under move out and enter second groove 362 from first groove 354, plunger 316 just can continue during the second portion of second stroke (referring to Figure 13 F) with respect to distad translation of collar 332, and then makes push rod 330 with respect to distad translation of ejector sleeve 334.

To at first referring to Fig. 7 A-D, Figure 13 A and Figure 14 A-D the operation of inserting apparatus 300 be described now.Particularly, insert apparatus 300 can be constructed such that proper plunger 316 and and then push rod 330 when being in primary importance, the first anchor log main body 28a and the second anchor log main body 28b are arranged in the intubate 310.In accordance with the embodiments illustrated, the first anchor log main body 28a vertically is arranged between the plug 314 that ejects port 442 and ejector sleeve 334.When the first pusher assembly 317(comprises plunger 316 and push rod 330) and the second pusher assembly 333(comprise collar 332 and ejector sleeve 334) when being in primary importance, coupling assembly is with respect to lengthwise movement and rotatablely move and connect the first pusher assembly 317 and the second pusher assembly 333 releasedly.Particularly, breech lock 370 extends in the two at first groove 354 and passage 358, thereby with respect to lengthwise movement with rotatablely move and connect plunger 316 and collar 332 releasedly.

Now specifically referring to Fig. 8 A-D, Figure 13 A-B and Figure 14 B, most advanced and sophisticated 311 can for example inject in the anatomical structure 24 at the second target anatomical position 24b place, extend to distally or the rear of anatomical structure 24 up at least a portion (for example distal part) that ejects port 442.In accordance with the embodiments illustrated, inserting apparatus can comprise from intubate 310 radially extended depth stop spares 383, this depth stop spare is configured in abutting connection with anatomical structure 24, in case and intubate 310 has been incident upon desired depth, depth stop spare 383 just provides resistance for intubate 310 to the further insertion in the anatomical structure 24, for example makes that ejecting port 442 is arranged on anatomical structure 24 rears.In this, depth stop spare 383 can be user tactile feedback is provided, and indication intubate 310 is injected desired depth in object construction 24.When housing 308 keeps static when distally power is applied to plunger 316, for example when distally power being applied to plunger 316, housing 308 grasping are got when static relatively when user, the first pusher assembly 317 and the second pusher assembly 333 along first stroke with respect to distad translation of housing 308.When the first pusher assembly 317 and the second pusher assembly 333 were distad advanced with respect to housing 308, pilot pin 344 was advanced along the first rail portion 342a proximad of collar 332, arrived the near-end 342a ' ' of the first rail portion 342a up to pilot pin 344.When the second pusher assembly 333 was distad advanced, plug 314 made second anchor log main body 28a biasing, with towards most advanced and sophisticated 311 distad translations.In addition, because the first pusher assembly 317 with the second pusher assembly 333 with respect to housing 308, and and then also with respect to distad translation of intubate 310, so push rod 330 is setovered the first anchor log main body 28b during first stroke downstream towards most advanced and sophisticated 311.

In case pilot pin 344 has arrived the near-end 342a ' ' of the first rail sections 342a, plug 314 is just with respect to the distad translation of near-end of ejecting port 442, and therefore the second anchor log main body 28b is biased to the position at anatomical structure 24 rears from ejection port 442 along direction of arrow B, for example the second target anatomical position 24b place (referring to Figure 1A).Therefore, the first rail portion 342a has longitudinal length, and this longitudinal length is enough to make pilot pin 344 along moving of the first rail portion 342a ejector sleeve 334 to be ejected the second anchor log main body 28b from inserting apparatus 300.In case plunger 316 and collar 332 have been finished first stroke, plug 314 just can be spaced away at most advanced and sophisticated 311 nearside.Be to be understood that, described about Figure 14 C as mentioned, the stop part that the near-end 342a ' ' that collar 332 limits the first rail portion 342a locates, this stop part also prevent collar 332 and and then ejector sleeve 334 and push rod 330 generation further distally translations before breech lock 370 is attached to housing 308.

Next referring to Fig. 9 A-D, as mentioned above, in case the second anchor log main body 28b ejects from inserting apparatus 300, just distally power can be removed from plunger 316, this will make the spring member 365 proximads for example collar 332 of the second pusher assembly 333 of setovering, and the therefore also proximad first pusher assembly 317 of setovering, the deviation post 342a ' ' ' with the first rail portion 342a aligns up to pilot pin 344.In case pilot pin is in deviation post 342a ' ' ', pilot pin 344 just aligns with intermediate orbit part 342c, and plunger 316 just can be rotated to the second rail portion 342b.

Whenever, the second anchor log main body 28b can be actuated to the expanded configuration shown in Figure 1B after finishing first stroke and before the first anchor log main body 28a ejects.For example, referring to Fig. 9 E, can remove to activate the second anchor log main body 28b from target anatomical structure 24 by inserting apparatus.Shown in Fig. 9 B, and as the more detailed description of hereinafter carrying out about Fig. 9 B, insert the strand maintenance assembly 390 that apparatus 300 comprises at least one tensioning strand 380 of maintenance (for example keeping releasedly), this at least one tensioning strand operationally is attached to actuation part 131a and the 131b of the first anchor log main body 28a and the second anchor log main body 28b, and proximad extends into the inside 328 of housing 308 and is connected to releasedly and keeps assembly 390.Can to the size of described at least one tensioning strand 380 set and with it along activating strand 131 location, make when tension force is applied to tensioning strand 380, for example when insertion apparatus 300 proximads are shifted out anatomical structure 24, and in certain embodiments, will insert apparatus 310 after anatomical structure 24 removes with it during further towards the nearside translation, tensioning strand 380 is conveyed to tension force and activates strand 131b, thereby the second anchor log main body 28b is actuated to its expanded configuration.Perhaps, user can manually be applied to actuation force corresponding actuation part 131b as required.Insert apparatus 300 and also can limit elongated side slit 315, this elongated side slit 315 extends through a radial side of intubate 310 in the position that is in nearside with respect to ejection port 442.For example, slit 315 can extend enough distances from ejecting port 442 proximads, and its size can be configured to be enough to make actuation part 131a-b and attachment part 133 can extend through slit 315 and be attached to the tensioning strand 380 that proximad extends into housing 308.Alternatively, described at least one tensioning strand 380 can be attached to the actuation part 131a-b in the intubate 310, and extends slit 315.Therefore, slit 315 can limit a circumferential width, this circumferential width is greater than the thickness that activates strand 38a-b and described at least one tensioning strand 380, but when anchor log main body 28a and 28b were in their corresponding first configurations in intubate 310, this circumferential width was less than the thickness of anchor log main body 28a and 28b.

Referring now to Figure 10 A-D, Figure 13 C-D and Figure 14 A-D,, in case the deviation post 342a ' ' ' that the second anchor log main body 28b has been ejected and pilot pin 344 is in the first rail portion 342a locates, and insert apparatus 300 and remove from anatomical structure 24, the tip 311 of insertion apparatus 300 just can be sentenced above at the first target anatomical position 24a and is launched in the anatomical structure 24 with respect to the described mode of the second target anatomical position 24b.Most advanced and sophisticated 311 before or after the first target anatomical position 24a place injects, plunger 316 can rotate along direction of arrow A, in order to advance along mid-stroke, make pilot pin 344 along intermediate orbit part 342c towards the second rail portion 342b translation.Plunger 316 can mediate up to plunger 316 along direction of arrow A rotation, and whereby, pilot pin 344 vertically aligns with the second rail portion 342b.In case plunger 316 and collar 332 have rotated to the centre position, plunger 316 and collar 332 just can be again with respect to housing 308 towards the distally translation, and breech lock 370 vertically aligns with second groove 362.

Referring now to Figure 11 A-D, Figure 13 D-E and Figure 14 D,, be not launched among the first target anatomical position 24a before mid-stroke is advanced in actuation plunger 316 if insert apparatus 300, then inserting apparatus 300 can be in actuation plunger 316 after mid-stroke be advanced but be launched among the first target anatomical position 24a before the second stroke translation in actuation plunger 316.When plunger 316 and collar 332 are distad further driven with respect to housing 308, the first pusher assembly 317 and the second pusher assembly 333 along the first of second stroke with respect to distad translation of housing 308.Plunger 316 makes pilot pin 344 move to the near-end of the second rail portion 342b and the position between the far-end from middle part proximad along the translation of the first of second stroke.

At plunger 316 with respect to housing 308 distad during translation, coupling assembly 350 makes collar 332, and and then make and comprise that plug 314 ejector sleeve 334 with respect to housing 308 and distad translation accordingly of intubate 310, becomes and second groove, 362 radially aligneds up to first groove 354.Therefore we can say that pilot pin 344 moves into second groove 362 breech lock 370 along moving of the second rail portion 342b to align.In case filling in 314 has moved to respect to most advanced and sophisticated 311 positions in the distally, and therefore be positioned at respect to ejecting the position of port 442 in the distally, second groove 362 just can be positioned such that breech lock 370 and second groove, 362 radially aligneds, in case along first's translation of second stroke, this situation just can take place plunger 316.Distad move to ejection port 442 because fill in 314, so when the first anchor log main body 28a ejected from intubate 310, plug 314 was just away from the interference of the first anchor log main body 28a.In addition, because push rod 330 and ejector sleeve 334 are along first's translation together of second stroke, so push rod 330 continues in the elongated open 312 of intubate 310 the first anchor log main body 28b to be setovered towards most advanced and sophisticated 311 downstream.When first groove 354 and second groove 362 when the first of second stroke and the transition position between the second portion become radially aligned, breech lock 370 is driven into second groove 362 from first groove 354.

Referring now to Figure 12 A-D, Figure 13 E-F and Figure 14 D,, in case breech lock 370 is arranged in second groove 352, the second pusher assembly 333 just is attached to housing 308 with respect to translation.Because breech lock 370 removes from first groove 354, so the first pusher assembly 317 breaks away from the second pusher assembly 333 with respect to translation.Therefore, the first pusher assembly 317 can be with respect to the second pusher assembly 333 and housing 308 and thereby also with respect to intubate 310 translations.Therefore we can say that push rod 330 breaks away from ejector sleeve 334 translations ground but breech lock 370 is moved into second groove 362, makes push rod 330 can be independent of ejector sleeve 344 and translation, in order to the first anchor log main body 28a is ejected from inserting apparatus 330.

In accordance with the embodiments illustrated, when the first pusher assembly 317 was further distad setovered with respect to the second pusher assembly 333 during the second portion of second stroke, plunger 316 and push rod 330 were with respect to housing 308 and thereby also with respect to distad translation of intubate 310.Therefore, push rod 330(is for example at its far-end) the biasing second anchor log main body 28b, so that it is with respect to plug 314 distal motion.Plug 314 can limit slideway 376 in its proximal end.Therefore slideway 376 can be arranged on the distally of ejecting port 442 and axle 302 location longitudinally, and during therefore when push rod 330 translation longitudinally and longitudinally with first anchor log main body 28a ejection intubate 310, slideway 376 aligns with the first anchor log main body 28a.Slideway 376 can limit taper and eject surface 378, and it is radially outward angled when distad extending that the surface is ejected in this taper.Therefore, when push rod 330 with respect to the situation lower push-rod 330 of plug 314 translations with first anchor log main body 28a biasing so that its distad move to when ejecting on the surface 378 from ejecting port 442, the first anchor log main body 28a takes along ejecting surface 378, this just guide the first anchor log main body 28a at the first target anatomical position 24a place away from insertion apparatus 300.Therefore, the second rail portion 342b has a longitudinal length, moves to the position in most advanced and sophisticated 311 distally to allow plug 314, makes the distally translation of push rod 330 that the first anchor log main body 28a is ejected from inserting apparatus.

Although coupling assembly 350 is configured to make collar 332 to move, move with plunger 316 and move with plunger 316 along the first of second stroke along mid-stroke with plunger 316 along first stroke, but be to be understood that, according to alternative embodiment, coupling assembly 350 can be configured to make after first stroke or during, but perhaps after mid-stroke or during collar 332 break away from from plunger 316 translations ground.

Referring now to Figure 12 E,, in case the first anchor log main body 28a has been incident upon the first target location 24a that is positioned at place, anatomical structure 24 rear positions, the first anchor log main body 28a just can be actuated to its expanded configuration.For example, user can be by with actuation force F(Figure 1A) be applied to corresponding actuation part 131a the first anchor log main body 28a is expanded.In accordance with the embodiments illustrated, the first anchor log main body 28a and the second anchor log main body 28b activates strand 38a accordingly and 38b can be shared strand.Therefore, actuation part 131a and actuation part 131b are in aggregates, and for example remove insertion apparatus 300 from anatomical structure 24 after, the nearside translation of inserting apparatus 300 can make insertion apparatus 300 that nearside tension force is applied on the tensioning strand 380, this tensioning strand is conveyed to the second anchor log main body 28b with this tension force, thereby the second anchor log main body 28b is actuated to its expanded configuration.

Referring now to Figure 15 A-E,, coupling assembly 350 can be constructed according to another embodiment, and in accordance with the embodiments illustrated, coupling assembly 350 can comprise at least one first coupling member 352, and described at least one first coupling member is depicted as and radially extends into for example first groove 354 of plunger 316 of the first pusher assembly 317.In accordance with the embodiments illustrated, coupling assembly 350 can comprise at least one second coupling member 356, and described at least one second coupling member is depicted as and radially extends through for example passage 358 of collar 332 of the second pusher assembly 333.In accordance with the embodiments illustrated, coupling assembly 350 also can comprise at least one the 3rd coupling member 360, and described at least one the 3rd coupling member is depicted as to extend radially outwardly and enters second groove 362(Figure 15 C of housing 308).In addition, in accordance with the embodiments illustrated, when plunger 316 was in primary importance shown in Fig. 7 A and Figure 13 A, second groove 362 was arranged on the distally with respect to passage 358.When plunger 316 was in primary importance shown in Fig. 7 A and Figure 13 A, second groove 362 also can be with respect to passage 358 radial deflections.Alternatively, second groove 362 can be with respect to second groove, 362 radially aligneds (for example, if track 342 does not comprise intermediate orbit part 342c), and also can be annular alternatively, thereby as required around the inner radial surface of housing 308.

Coupling assembly 350 also can comprise at least one the tetrad connection member 368 that is depicted as breech lock 370, and the size of breech lock 370 is configured to partly fit in first groove 354 and second groove 362 each.In accordance with the embodiments illustrated, breech lock 370 is roughly sphere, and each the be roughly part sphere in first groove 354 and second groove 362, but should be appreciated that in breech lock 370 and first groove 354 and second groove 362 each can limit any suitable shape as required.The size of breech lock 370 also can be configured to can be arranged in the passage 358, passage 358 can be the form of slit, described slit is limited by the longitudinal size of the longitudinal size that is substantially equal to breech lock 370, and is limited by the radial dimension of the radial dimension that is substantially equal to breech lock 370.Therefore, breech lock 370 can be along first groove 354(Figure 15 A-B) and second groove 362(Figure 15 D-E) between passage 358 advance.

In accordance with the embodiments illustrated, coupling assembly 350 is under first operator scheme when pilot pin 344 is arranged in the first rail portion 342a, and remain under first operator scheme when the first rail portion 342a marches to intermediate orbit part 342c at pilot pin 344, and still remain under first operator scheme when the part of the second rail portion 342b is advanced at pilot pin 344.Particularly, first groove 354 and passage 358 can be positioned, extend in the part of the second rail portion 342b as shown in the figure with convenient pilot pin 344, among the first rail portion 342a and the intermediate orbit part 342c any one or all the time, they are with radially aligned.In addition, breech lock 370 limits a radial dimension, this radial dimension is substantially equal to the merging radial dimension of first groove 354 and passage 358, and the merging radial dimension of described first groove 354 and passage 358 is substantially equal to the merging radial dimension of passage 358 and second groove 362.Therefore, the radial dimension of breech lock 370 also is substantially equal to the merging radial dimension of passage 358 and second groove 362.Therefore it is also understood that first groove 354 and second groove 362 can limit substantially the same radial dimension.

Therefore, under first operator scheme, breech lock 370 partly is arranged in first groove 354 of plunger 316, and extends into the passage 358 of collar 332.Can set the size of breech lock 370, so that it is trapped between housing 308 and the plunger 316, and make it in passage 358, extend through collar 332.Because first groove 354 is shaped as in a part that vertically upwards is substantially equal to breech lock 370 with week, so when breech lock 370 is arranged in first groove 354, the lengthwise movement of plunger 316 and rotatablely move and correspondingly make breech lock 370 carry out lengthwise movement respectively with plunger 316 and rotatablely move.In addition, because the size of passage 358 is configured to vertically and upwards all be substantially equal to the size of breech lock 370 week, so the lengthwise movement of breech lock 370 and rotatablely move and correspondingly make collar 332 carry out lengthwise movement respectively and rotatablely move.Therefore, when breech lock 370 is arranged in first groove 354 and the passage 358, plunger 316 and collar 332 and and then the first pusher assembly 317 and the second pusher assembly 333 connect with respect to longitudinally motion or translation, and further connect with respect to radially rotation or motion.

Referring now to Figure 15 C-E,, because in accordance with the embodiments illustrated, second groove 362 is shaped as a part that is substantially equal to breech lock 370, so when breech lock 370 is moved into second groove 362 from first groove 354, breech lock 370 breaks away from the first pusher assembly 317 and the second pusher assembly 333, and make the second pusher assembly 333, be in particular collar 332 with respect to translation at least and be attached to housing 308, and also can make collar 332 be attached to housing 308 with respect to rotation.As mentioned above, housing 308 is with respect to translation at least and be fixed to intubate 310, and can be fixed to intubate 310 with respect to translation.In accordance with the embodiments illustrated, when plunger 316 makes that to the centre position pilot pin 344 is advanced along intermediate orbit part 342c from second position rotation (referring to Figure 13 C-D), first groove 354 and passage 358 vertically align with second groove 362.

During the first of second stroke (referring to Figure 13 E), plunger 316 and collar 332 longitudinal translations align with second groove 362 of housing 308 up to first groove 354 and passage 358.At first and the transition period between the second portion (also referring to Figure 13 F) of second stroke, breech lock 370 driven (for example cam) goes out first groove 352 and therefore is moved into second groove 362 from first groove 352.According to alternative embodiment, plunger 316 can comprise spring member, and this spring member is radially outward setovered breech lock 370 and made it enter second groove 362 from first groove 352.Perhaps, can be arranged so that when plunger 316 and collar 332 pass through second groove, 362 translations of housings 308 that breech lock 370 can go out and is moved into second groove 362 from first groove from first groove, 352 cams with inserting apparatus 300.In case move out and enter second groove 362 from first groove 354 under the situation of breech lock 370 in keeping being arranged on the passage 358 of collar 332, plunger 316 just can continue during the second portion of second stroke with respect to distad translation of collar 332 (referring to Figure 13 F), and then makes push rod 330 with respect to distad translation of ejector sleeve 334.

Referring now to Figure 16 A-17D,, anchor log assembly 20 can comprise at least one take up member, for example can pass the corresponding first actuating strand 38a of the first anchor log main body 28a and the second anchor log main body 28b and second and activate the tensioning strand 380 that strand 38b sews up.Anchor log assembly 20 can comprise many required tensioning strands, and described tensioning strand extends through first and activates strand 38a and second one or both that activates among the strand 38b.The mid portion 380 ' of extension between tensioning strand 380 limits first end 380 ', second end 380 ' ' and at first end 380 ' and second end 380 ' ' ' '.

Tensioning strand 380 can pass among anchor log main body 28a and the 28b at least one first and activate strand and sew up.In accordance with the embodiments illustrated, tensioning strand 380 passes first and activates strand, and the first actuation part 131a and the first attachment part 133a that pass the first anchor log main body 28a particularly sew up.For example, can be with the first tensioning strand 380a around to pin, described pin is driven through first and activates strand 38a, in order to insert tensioning strand 380 by activating strand 38a, make tensioning strand 380 be connected in the position than the more close first anchor log main body 28a of the second anchor log main body 28b and activate strand 38a.

Referring now to Fig. 7 C and Figure 17 A-D,, insert apparatus 300 and can comprise for example strand maintenance assembly 390 of maintenance assembly, described maintenance assembly is configured to keep at least one tensioning strand 380, is in particular the first terminal 380a ' and second end 380 ' of tensioning strand 380 '.According to an embodiment, keep assembly to keep tensioning strand 380 releasedly.Describe as being about to now, but keep assembly 390 translations ground to be fixed to the first pusher assembly 317, and so with plunger 316 longitudinally L towards nearside and distal movement.Therefore, the implantation for the first anchor log main body 28a and the second anchor log main body 28b provides enough relaxing to tensioning strand 308 at corresponding target anatomical position 24a and 24b place.At the second anchor log main body 28b after intubate 310 ejects, for example when removing apparatus from anatomical structure 24, the proximal movement of inserting apparatus 300 makes and keeps assembly 390 to move along proximal direction, thereby the stretching actuation force is applied to the second tensioning strand 380, this second tensioning strand is conveyed to second with described actuation force and activates the second actuation part 131b of strand 38b, and the second anchor log main body 28b is expanded.Similarly, at the first anchor log main body 28a after intubate 310 ejects, for example when removing apparatus from anatomical structure 24, the proximal movement of inserting apparatus 300 makes and keeps assembly 390 to move along proximal direction, thereby the stretching actuation force is applied to tensioning strand 380, this tensioning strand is conveyed to first with actuation force and activates the first actuation part 131a of strand 38a, and the first anchor log main body 28a is expanded.

In accordance with the embodiments illustrated, keep assembly 390 to comprise the maintenance shell 392 with housing main body 394, be attached to the far-end 316a of plunger 316 by plunger 316 direct or indirect these housing main bodies 394 that support.Housing main body 394 also is attached to from the push rod 330 that keeps assembly 390 distad to extend.Keep shell 392 to comprise from first locking component 400 and second locking component 402 of the terminal relatively extension of terminal relatively for example side direction of housing main body 394.First locking component 400 and second locking component 402 are configured to keep corresponding first relative terminal 380 ' the relative end 380 ' with second of tensioning strand 380 '.First locking component 400 is configured to be in disengaged position, in order to discharge first end 380 '.Second locking component 402 is configured to keep second end 380 ' of tensioning strand 380 when first locking component 400 is released '.

In accordance with the embodiments illustrated, first locking component 400 comprises locking main body 407, and the clip 409 that is configured to be removably fixed to locking main body 407.For example, clip 409 can hingedly be attached to locking main body 407 as required, or in other words is attached to locking main body 407 movingly.Keep shell 392 can limit the maintenance passage 411 that is arranged between locking main body 407 and the clip 409.Keep passage 411 can have any suitable shape as required, and limit helical type shape in accordance with the embodiments illustrated.When clip 409 was fixed to locking main body 407, maintenance passage 411 had the thickness less than the thickness of first end 380 ' of tensioning strand 380.As described in greater detail below, clip 409 comprises outwards outstanding release protuberance 413, this release protuberance is configured to receive release force in order to clip 409 is discharged from locking main body 407, thereby first end 380 ' that keeps strand 380 is discharged from keeping assembly 39.

In accordance with the embodiments illustrated, second locking component 402 comprises the second locking main body 415, and the second clamp 417 that is configured to be fixed to the second locking main body 415.Keep shell 392 to limit and be arranged on the second second maintenance passage 419 that locks between main body 415 and the second clamp 417.Second keeps passage 419 can have any suitable shape as required, and limits helical type shape in accordance with the embodiments illustrated.When second clamp 417 is fixed to second locking during main body 415, second keeps passage 419 to have second end 380 ' less than tensioning strand 380 ' the thickness of thickness.

Therefore, during operation, first end 380 ' of tensioning strand 380 is extensible to be passed first and keeps passage 411 and clip 409 can be fixed to locking main body 407, thereby first end 380 ' of tensioning strand 380 is locked in first locking component 400 releasedly.Similarly, second end 380 ' of tensioning strand 380 ' extensiblely pass second and keep passage 419 and second clamp 417 can be fixed to the second locking main body 415, thereby with second end 380 ' of tensioning strand 380 ' be locked in releasedly in second locking component 402.When first end 380 ' and second end 380 ' ' be fixed to when keeping assembly, in case the first anchor log 28a and the second anchor log 28b implanted with so that the stretching actuation force is sent to tensioning strand 380, but insert just proximad translation of apparatus, wherein said tensioning strand 380 is conveyed to the corresponding actuation part of anchor log main body with the stretching actuation force, thereby the anchor log main body is expanded in described mode above.

Keep assembly 490 also to comprise the actuator 421 that is configured to discharge first locking component 400.Particularly, actuator 421 can comprise by the actuator of housing 308 carrying or button 423(referring to Fig. 7 C), and at least one biasing member for example extends into a pair of arm 425 of the inside 328 of housing 308 from button 423.Finished second stroke in case have realized that plunger 316, the first anchor log main body 28a just ejects from apparatus 300.Therefore, actuator 421 is positioned, in case make plunger 316 arrive the last of second stroke, described arm just contacts and keeps shell 492.

Referring to Figure 12 C and Figure 17 C, along with plunger 316 arrives the last of second stroke, arm 425 is taken along the outer surface of the first locking main body 407 and the second locking main body 415 respectively, this make button 423 never " loaded " position radially outward to " loaded " position.In case plunger 316 has arrived the last of second stroke, one of them arm just aligns with release protuberance 413.Therefore, can press the button 423, make one in the arm 425 drive described release protuberance 413 away from the first locking main body 407, make clip 409 be moved into unlocked position, thus, clip 409 is the enough amounts of motion from locking main body 407 just, make that maintenance passage 411 is thicker than first end 380 ' of tensioning strand 380.Therefore, first end 380 ' is from keeping assembly 390 releases, but and the apparatus proximal motion so that tractive tensioning strand 380 passes the actuating strand of anchor log main body.

Referring now to Figure 18 A,, anchor log assembly 20 can or comprise a pair of take up member, and the first actuating strand 38a and second that for example can pass the first anchor log main body 28a and the second anchor log main body 28b respectively activates the first tensioning strand 380a and the second tensioning strand 380b that strand 38b sews up.Anchor log assembly 20 can comprise many required tensioning strands, and described tensioning strand extends through first and activates strand 38a and second one or both that activates among the strand 38b.The mid portion 380a ' ' ' that the first tensioning strand 380a limits the first terminal 380a ', the second terminal 380a ' ' and extends between the first terminal 380a ' and the second terminal 380a ' '.Similarly, the second tensioning strand 380b limits the first terminal 380b ', the second terminal 380b ' ' and the mid portion 380b ' ' ' of extension between the first terminal 380b ' and the second terminal 380b ' '.

The first tensioning strand 380a can pass first and activate strand 38a, for example passes first end relatively that activates strand 38a and sews up.For example, can be with the first tensioning strand 380a around to pin, described pin is driven through first and activates strand 38a, inserts the first tensioning strand 380a in order to activate strand 38a by first.The extensible first attachment part 133a and the first actuation part 131a that passes the first actuating strand 38a of the first tensioning strand 380a, and can pass the first actuation part 131a and the first attachment part 133a by the position loopback between the first anchor log main body 28a and the second anchor log main body 28b.

Similarly, the second tensioning strand 380b can pass second and activate strand 38b, for example passes second end relatively that activates strand 380b and sews up.For example, can be with the second tensioning strand 380b around to pin, described pin is driven through second and activates strand 38b, inserts the second tensioning strand 380b in order to activate strand 38b by second.The extensible first attachment part 133b and the first actuation part 131b that passes the second actuating strand 38b of the second tensioning strand 380b, and can pass the second attachment part 133b and the second actuation part 131b by the position loopback between the first anchor log main body 28a and the second anchor log main body 28b.

Referring now to Figure 19 A-B,, strand keeps assembly 390 to construct according to alternative embodiment, in order to keep at least one tensioning strand 380 releasedly.Therefore, although keeping assembly 390 to be shown as, the strand shown in Figure 19 A-B keep the described strand of the first tensioning strand 380a and the second tensioning strand 380b right, but keep assembly 390 can or can keep single tensioning strand, for example above with respect to Figure 16-17 description with discharging.According to the embodiment shown in Figure 19 A-B, keep the first terminal 380a ' and the second terminal 380b ' of the assembly 390 maintenances first tensioning strand 380a, and the first terminal 380a ' ' of the second tensioning strand 380b and the second terminal 380b ' '.According to an embodiment, keep assembly 390 to keep the first tensioning strand 380a and the second tensioning strand 380b releasedly.Describe as being about to now, but keep assembly 390 translations ground to be fixed to the first pusher assembly 317, and so with plunger 316 longitudinally L towards nearside and distal movement.Therefore, at the second anchor log main body 28b after intubate 310 ejects, plunger 316 and the motion of push rod 330 on proximal direction make and keep assembly 390 to move in proximal direction, thereby the stretching actuation force is applied to the second tensioning strand 380b, this second tensioning strand is conveyed to second with described actuation force and activates the second actuation part 131b of strand 38b, and the second anchor log main body 28b is expanded.Similarly, at the first anchor log main body 28a after intubate 310 ejects, plunger 316 and the motion of push rod 330 on proximal direction make and keep assembly 390 to move in proximal direction, thereby the stretching actuation force is applied to the first tensioning strand 380a, this first tensioning strand is conveyed to first with described actuation force and activates the first actuation part 131a of strand 38a, and the first anchor log main body 28a is expanded.

Keep assembly 390 to comprise and keep shell 392, this maintenance shell 392 to have the housing main body 394 that is directly or indirectly supported by housing 308.In accordance with the embodiments illustrated, keep shell 392 to be arranged on the inside 328 of housing 308, yet keep shell 392 can or to be carried on the outside of housing 308, and can be attached to plunger 316, or be attached to any suitable alternative structure of inserting apparatus 300 as required.Keep shell 392 to limit the bore hole 396 that enters housing main body 394 along the proximal direction longitudinal extension.In accordance with the embodiments illustrated, bore hole 396 longitudinal extensions pass housing main body 394.Housing main body 394 can limit at least one inner surface 398, and described at least one inner surface 398 limits the girth of bore hole 396.When inner surface 398 can march to the near-end of housing main body 394 at the far-end from housing main body 394 along a direction towards nearside radially outward-dipping (for example linear tilt, curve tilt or tilt along any suitable alternative shape).Therefore, the direction that bore hole 396 can be substantially perpendicular to longitudinal axis 302 along first or proximal end at longitudinal axis 302 limits the first cross sectional dimensions D3, and limits the second cross sectional dimensions D4 along the direction that is substantially perpendicular to longitudinal axis 302 at second or far-end of longitudinal axis 302.Because bore hole 396 can be convergent, so the first cross sectional dimensions D3 may be less than the second cross sectional dimensions D4.Bore hole 396 can be convergent, for example linear tapered, curve convergent, or on demand along any suitable alternative shape convergent.

Keep assembly 390 also can comprise first locking component 400 that is arranged in the bore hole 396.First locking component 400 for example has a cross sectional dimensions D5 along the direction that is substantially perpendicular to longitudinal axis 302, and this cross sectional dimensions D5 is between the first cross sectional dimensions D3 and the second cross sectional dimensions D4.First locking component 400 can be roughly sphere as shown in the figure, or can be used as another and select to limit as required Any shape.Keep assembly 390 to be configured at least one strand remained between the inner surface 398 of first locking component 400 and housing main body 394.For example, at least one among tensioning strand 380a ' and the 380b ' or both first ends can extend between first locking component 400 and inner surface 398.First locking component 400 is configured to operating period at apparatus against inner surface 398, thereby the first terminal 380a ' and 380b ' are captured between the inner surface 398 of first locking component 400 and housing main body 394, and prevent each among the first terminal 380a ' and the 380b ' and keep between the shell 392 relative motion taking place.Therefore, first locking component 400 can present first locking surface, and inner surface 398 can present second locking surface, this second locking surface cooperates with first locking surface, in order to keep strand 380a and second to keep the first terminal 380a ' of strand 380b and 380b ' to remain in the maintenance assembly 390 with first.

Keep assembly 390 also can comprise second locking component 402 that is configured to be attached to first locking component 400.Particularly, second locking component 402 can comprise the thread plug 403 of the near-end that inserts housing main body 394 threadably.Therefore, second locking component 402 can be close to cone-shaped inner surface 398 and arrange, and can be near the near-end of taper bore 396.Alternatively, second locking component 402 can be in aggregates with housing main body 394.Second locking component 402 limits for example longitudinal opening 404 of at least one opening, described at least one opening is configured to hold the end of one or more tensioning strand, the tensioning strand between described end and the inner surface 398 that is captured in first locking component 400 and housing main body 394 terminal relative.Therefore, second locking component 402 is configured to hold the second terminal 380a ' ' of the first tensioning strand 380a and the second tensioning strand 380b and each among the 380b ' '.Therefore second locking component 402 can align with taper bore 396, makes each the second terminal 380a ' ' and the 380b ' ' among win strand 380a and the second strand 380b extend through taper bore 396 and be attached to second locking component 402.

In accordance with the embodiments illustrated, longitudinal opening 404 is longitudinal extension between the outside of bore hole 396 and plug 403, and the outside of this plug 403 can be the inside 328 of housing 308.Among the second terminal 380a ' ' and the 380b ' ' each or both can tie up in the proximal end of longitudinal opening 404 and be tied in a knot 406, make to tie 406 near-ends in abutting connection with second locking component 402.Therefore, keep assembly 390 to be configured to fix the first terminal 380a ' and the second terminal 380a ' ' of the first tensioning strand 380a, and be configured to fix the first terminal 380b ' and the second terminal 380b ' ' of the second tensioning strand 380b.Alternatively or in addition, the second terminal 380a ' ' and 380b ' ' can extend between first locking component 400 and inner surface 398, and can be captured in as required between first locking component 400 and the inner surface 398, in order to the second terminal 380a ' ' and 380b ' ' are remained in the maintenance assembly 390.Second locking component 402 also can comprise and longitudinal opening 404 isolated second longitudinal openings 405.Second longitudinal opening 405 is configured to hold the first terminal 380a ' that is trapped between first locking component 400 and the inner surface 398 and the residue of 380b '.

Referring to Figure 19 C, the first pusher assembly 317 can comprise the pair of flanges 319 of outwards giving prominence to from plunger 316, in order to be limited to the gap 321 of extending between the flange 319.The size in gap 321 can be configured to hold housing main body 394, makes each near-end and far-end of latch housing main body 394 respectively in the flange 319.Therefore, the proximal movement of plunger 316 make distally in the flange 319 that with housing main body 394 biasings and thereby will keep assembly 390 biasings, thereby with plunger 316 also thereby also with push rod 330 proximal motion.Similarly, the distal movement of plunger 316 make nearside in the flange 319 that with housing main body 394 biasings and thereby will keep assembly 390 biasings, thereby with plunger 316 also thereby also with push rod 330 distal motion.

During operation, because plunger 316 and push rod 330 are along first stroke and second stroke distal motion in tandem, and because the first anchor log main body 28a and the second anchor log main body 28b are with push rod 330 distal motion, so keep assembly 390 equally with the first anchor log main body 28a and the second anchor log main body 28b distal motion.Therefore, before the first anchor log main body 28a and the second anchor log main body 28b eject from intubate 310, keep assembly 290 can operate so that not in any one in the first tensioning strand 380a and the second tensioning strand 380b, and thereby do not activate strand 38a and second corresponding first and activate among the strand 38b and cause tension force.Yet, describe as being about to now, insert apparatus 300, be in particular that plunger 316 can activated in order to after intubate 310 ejects corresponding first actuation force and second actuation force are applied to the first anchor log main body 28a and the second anchor log main body 28b in the first anchor log main body and the second anchor log main body.

For example, referring now to Fig. 8 A-D and Figure 19 A-B,, in case plunger 316 is advanced along first stroke, thereby eject the second bone anchor log 28b at position and the second anatomical position 24b place in anatomical structure 24 back from intubate 310, but just proximad translation of plunger 316 makes pilot pin 344 take along the first rail portion 342a along distal direction, up to contact collar 332, this just provides stop surfaces at the far-end of the first rail portion 342a, thereby prevents that plunger from further nearside translation taking place.Because the contact preventing second anchor log main body 28b of anatomical structure 24 between the second anchor log main body 28b and the 390 proximad translations of maintenance assembly, so keep assembly that tension force is applied to tensioning strand 380b, described tension force is communicated to second as actuation force and activates strand 38b, thereby makes the second anchor log main body 28b move to the expanded configuration shown in Fig. 9 E from first configuration shown in Fig. 9 A.

For example, referring now to Fig. 9 A-E and Figure 19 A-B,, in case plunger 316 is advanced along first stroke, thereby eject the second bone anchor log 28b position after the anatomical structure 24 at the second anatomical position 24b place from intubate 310, insert just proximad translation during removing from anatomical tissue 24 as mentioned above of apparatus 300.Because the contact preventing second anchor log main body 28b of anatomical structure 24 between the second anchor log main body 28b and the 300 proximad translations of insertion apparatus, so keep assembly 390 that tension force is applied to tensioning strand 380b, described tension force is communicated to second as actuation force and activates strand 38b, thereby makes the second anchor log main body 28b move to the expanded configuration shown in Fig. 9 E from first configuration shown in Fig. 9 A.

Similarly, referring now to Figure 18 A-E and Figure 19 A-B,, in case plunger 316 is advanced along the second portion of second stroke, thereby eject the first bone anchor log 28a position after the anatomical structure 24 at the first anatomical position 24a place from intubate 310, inserting apparatus 300 just can proximad translation during removing from anatomical tissue 24.Because the contact preventing first anchor log main body 28a of anatomical structure 24 between the first anchor log main body 28a and the 390 proximad translations of maintenance assembly, so keep assembly 390 that tension force is applied to the first tensioning strand 380a, described tension force is communicated to first as actuation force and activates strand 38a, thereby makes the first anchor log main body 28a move to the expanded configuration shown in Figure 12 E from first configuration shown in Figure 12 A.

In case the first anchor log main body 28a and the second anchor log main body 28b have been actuated to its expanded configuration, tensioning strand 380a and 380b just can discharge from keeping assembly 390.For example, as described in being about to now, keep assembly 390 can be configured to discharge in the end of tensioning strand 380a and 380b.Alternatively, as described in greater detail below, insert apparatus 300 and can comprise the cutter that are configured to cut off the first tensioning strand 380a and the second tensioning strand 380b.Referring to Figure 19 C, insertion apparatus 300 can comprise being attached to and keep assembly 390 and be configured to keep assembly 390 iteration to the release component 408 of unlocked configurations.Release component 480 can comprise any suitable linkage 410 that can align with first locking component 400.Shown in Figure 19 B, release component 408 can comprise the actuator 414 that is carried and be attached to linkage 410 by housing 308, but make user operated actuator 414, proximad sliding actuator for example, in order to make linkage 410 contacts first locking component 400, and making first locking component 400 bias to unlocked configurations along the direction of arrow 401 proximads, this has just formed gap 412 between first locking component 400 and inner surface 398.This gap can be greater than the cross sectional dimensions of tensioning strand 380a and 380b.

As the second terminal 380a ' ' and 380b ' ' during at second locking component, 402 place tying-ups, inserting apparatus 300 outwards advances the first terminal 380a ' of the first tensioning strand 380a and the second tensioning strand 380b and 380b ' to pass the gap with respect to the nearside translation of the anchor log main body 28a that implants and 28b and goes out from keeping assembly 390, and further the corresponding first tensioning strand 380a of tractive and the second tensioning strand 380b pass corresponding actuating strand 38a and 38b, thereby shown in Figure 18 C-18D the first tensioning strand 380a and the second tensioning strand 380b are removed from activating strand 38a and 38b.Alternatively, if the first terminal 380a ' ' and the second terminal 380b ' ' by first locking component 400 but not second locking component 402 keep, then insert apparatus 300 and with respect to the nearside translation of the anchor log main body 28a that implants and 28b tensioning strand 380a and 380b will be removed from inserting apparatus 300.Then user manually tractive tensioning strand 380a and 380b pass corresponding actuating strand 38a and 38b, in order to the first tensioning strand 380a and the second tensioning strand 380b are removed from activating strand 38a and 38b.

Referring now to Figure 18 D,, in case tensioning strand 380a and 380b remove from activating strand 38a and 38b, user just can be towards anatomical structure tractive adapter 63.Should be appreciated that as the first anchor log main body 28a and the second anchor log main body 28b to be loaded in when inserting in the apparatus 300 that adapter 63 can be attached to and activate strand 38a and 38b.Alternatively, user can activate strand 38a and 38b with being connected after the second anchor log main body 28b has ejected at the first anchor log main body 28a.Although the connector members 63 shown in Figure 18 C-E is configured to the knot of type mentioned above, connector members 63 can or be configured as required.According to the embodiment shown in Figure 18 C-E, tension force can be applied to free end 70, this makes connector members towards the anatomical structure translation, thereby engaging force is applied to actuating strand 38a and 38b, and then joining tissue gap 24c.Can cut off as required then from the part of connector members 63 outward extending actuating strand 38a and 38b.

Referring now to Figure 20 A-B,, and as mentioned above, insert apparatus 300 and can comprise cutting assembly 416, this cutting assembly comprises cutter 418, and can move between disengaging configuration and bonding station, at described disengaging configuration, cutter 418 are with spaced apart by one of the tensioning strand 380a that keeps assembly 390 to keep and the end of 380b (for example first terminal 380a ' and the 380b '), and at described bonding station, cutter cut off the first terminal 380a ' and the 380b ' of tensioning strand 380.Be to be understood that, maintenance assembly 390 shown in Figure 20 A-B can be configured as shown in Figure 17, and keep assembly 390 can be attached to single tensioning strand, make cutter 418 be configured to cut first end of single tensioning strand, tensioning strand tractive passed and away from activating strand 38a and 38b from removing of anchor log main body 28a and 28b thereby make to insert apparatus 300.

Cutting assembly 416 can comprise elongated in the vertical axle 420 and transducer 422, and this transducer 422 is connected between slender axles 420 and the cutter 418 pivotly, thereby slender axles 420 are attached to cutter 418.Cutter 418 can make slender axles 420 and transducer 422 be attached to cutter 418 indirectly by 424 carryings of cutter shell.Vertically the near-end of slender axles 420 can extend housing 408 towards nearside, and longitudinal axis can extend in the sidewall of housing 408.Axle 420 can be on distal direction from the disengaging configuration lengthwise movement to bonding station.The distal movement of axle 420 pivots transducer, thereby drives cutter 418 proximad translations and enter the first tensioning strand 380a and first terminal 380a ' and the 380b ' of the second tensioning strand 380b, thereby cuts off first terminal 380a ' and the 380b '.In case tensioning strand 380a and 380b are cut off, apparatus just can be with respect to anchor log main body 28a and the translation of 28b proximad of ejecting, in order to adopt mode mentioned above that tensioning strand 380a and 380b are removed from corresponding actuating strand 38a and 38b.

Referring now to Figure 21 A and Figure 21 B,, should be appreciated that cutting assembly 416 can construct according to any alternative embodiment as required.For example, cutting assembly 416 can comprise actuator 426, and this actuator laterally extends the sidewall of housing 408 along the direction that is offset with respect to vertical L angledly, and can radially inwardly move to bonding station from disengaging configuration.Actuator 426 can carry cutter 418.Therefore, when actuator 426 radially inwardly moved, the first terminal 380a ' and the second terminal 380b ' that cutter 418 will activate strand 380a and 380b cut off.Insert apparatus 300 and can comprise dividing wall 428, this dividing wall will activate first end and second terminal separation of strand 380a and 380b, and align with cutter 418.Therefore, cutter 418 drive to enter dividing wall 428 and do not cut off first and activate second end that strand 380a and second activates strand 380b.Of course it is to be understood that single tensioning strand can be attached to the actuating strand 38 of anchor log assembly 20 as mentioned above, make cutter 418 can cut one in first terminal and second end of single tensioning strand.

Now totally referring to Figure 22 A-D, inserting apparatus 300 can construct about Fig. 7 A-21B is described basically as mentioned, but can comprise guidance system 329, this guidance system is coupling housing 308 and push rod 330 operationally, so that according to the relative motion between another embodiment guide housing 308 and the push rod 330.For example, as mentioned above, guide rail 342 can be limited in the collar 332, but longitudinally L substantial linear ground extends.Therefore, when plunger along first stroke and second stroke distad during translation, guide rail 342 is with respect to pilot pin 344 translation linearly.Be to be understood that, in the embodiment shown in Figure 22 A-D, second groove 362 shown in Figure 13 C-E can align in the vertical with first groove 354, make breech lock 370 be moved into second groove 362 from first groove 354, in order to plunger 316 and collar 332 are broken away from.Plunger 316 can comprise shaft portion 430 and distal end cap, and shaft portion 430 limits the part of aforesaid key 318, and distal end cap can limit the grip portion 432 that extends radially outwardly from the near-end of shaft portion 430.In accordance with the embodiments illustrated, collar 332 can extend around shaft portion 430 at least in part, and can extend radially outwardly from shaft portion 430.

Insert apparatus 300 and also can comprise clip 434, clip 434 has longitudinal length, and when plunger 316 was positioned at primary importance, this longitudinal length was substantially equal to the fore-and-aft distance between the near-end of the grip portion 432 of plunger 316 and collar 332.Clip 434 can be removably fixed to the shaft portion 430 of plunger 316.Therefore, when plunger 316 distad during translation, against collar 332 biasings, this makes collar 332 with plunger 316 translations to grip portion 432 with clip 434.Therefore it should be understood that clip 434 with respect to the distally translation of L longitudinally and connect plunger 316 and collar 332.Therefore, during operation, plunger 316 and collar 332 can adopt mode mentioned above distad to move to the second position from primary importance in tandem along first stroke.When plunger 316 and collar 332 during along first stroke movement, pilot pin 344 proximad translation in whole guide rail 342.When clip 434 during in abutting connection with housing 308, plunger 316 and collar 332 arrive the second positions, and described about Figure 14 C-D as mentioned at this moment, latch member 370 is moved into second groove 358 from first groove 354.Next, clip 434 can be removed from plunger 316, and plunger 316 can be along second stroke with respect to distad translation of collar 332.Should be appreciated that plunger 316 can be independent of collar 332 along the whole second stroke translation.

Therefore, at plunger and collar 332 along first stroke after primary importance moves to the second position, ejector sleeve 334 ejects the second anchor log main body 38b about Fig. 9 A-E is described as mentioned.Therefore, plunger 316 can be depressed first distance, make the second anchor log main body 28b eject from inserting apparatus, in case and plunger 316 first distance that has been depressed, clip 434 is just in abutting connection with housing 308, in order to collar 434 was being prevented that plunger 316 was depressed greater than the second distance of first distance before plunger 316 removes.By after above moving to the 3rd position along second stroke from the second position about the described mode of Figure 12 A-E, push rod 330 can eject the first anchor log main body 28a subsequently at plunger 136.When finishing second stroke, pilot pin 344 can be in abutting connection with the near-end of guide rail 342.In addition, in case plunger 316 has been finished second stroke and moved to the 3rd position, the grip portion 432 of plunger 316 just can be in abutting connection with housing 308.Be to be understood that, in the embodiment shown in Figure 22 A-D, because plunger 316 rotatably is bonded to collar 332, therefore and rotatably be fixed to collar 332, and because breech lock 370(is mentioned above) collar 332 rotatably is attached to housing 308, so plunger 316 can not be with respect to housing 308 rotations along the second stroke translation time.Alternatively, as mentioned above, insert apparatus and can be configured to allow plunger 316 to rotate as required, in order to breech lock 370 is alignd with second groove 362.

Described about the insertion apparatus shown in Fig. 7 A-13G as mentioned, guide rail 342 can be carried by housing 308, and pilot pin 344 can be by wherein carryings of pusher assembly.Referring now to Figure 23 A,, insert apparatus 300 and comprise at least one guide rail, for example first guide rail 446 that is carried by housing 308, and at least one ways is for example taken first pilot pin 448 that is also carried by plunger 316 particularly by 317 carryings of pusher assembly in first guide rail 342.

As shown in Figure 23 B, the shaft portion 430 of plunger 316 limits distal surface 431, and limits first centre bore 440 that longitudinal extension entered or distad extended into distal surface 431.The shaft portion 430 of plunger 316 also limits the radial hole 435 that holds pilot pin 448.First hole 440 holds push rod 330, makes plunger 316 and push rod 330 with respect to longitudinal translation and rotate the two to be coupled to each other.Shown in Figure 23 D, push rod 330 extends and enters intubate 310 from plunger 316, and this intubate is fixed to housing 308 with respect to translation and rotation.Also referring to Figure 23 C, most advanced and sophisticated 311 can be hollow, in order to limit with longitudinal axis 302 substantial alignment and therefore also eject port 442 with the distally of elongated open 312 substantial alignment of intubate 310.Push rod 330 is so that above described mode can be in passage 312 inner lengthwise movements.Should be appreciated that inserting apparatus 300 can or limit side ejection port of constructing as mentioned below substantially.Intubate 310 can limit vertical slit 337, makes the first anchor log main body 28a is attached to the attachment part 133a of the actuating strand 38a of the second anchor log main body 28b and 38b and 133b(referring to Figure 1A) can extend slit 337.

Also referring to Figure 23 D-E, insert apparatus and comprise guidance system 444 now, this guidance system is configured to housing 308 operationally is attached to push rod 330, so that the relative motion between guide housing 308 and the push rod 330.For example, guidance system 444 comprises first ways and second ways, and described first ways is the form by first guide rail 446 of housing 308 carryings, and described second ways is depicted as first pilot pin 448 that extends from pusher assembly 317.First guide rail 446 can be configured to the extend radially outwardly slit of the inner radial surface that enters housing 308.In addition, in accordance with the embodiments illustrated, first pilot pin 448 extends radially outwardly from the shaft portion 430 of plunger 316, and takes in first guide rail 448.First guide rail 446 limits the first rail portion 446a of longitudinal extension basically, and from the circumferential intermediate orbit part 446b that extends of the far-end of the first rail portion 446a.

Continuation is referring to Figure 23 E, and guidance system 444 also comprises the 3rd ways, and the 3rd ways is configured to second guide rail 450 by housing 308 carrying, and is configured to extend radially outwardly and enters the slit of housing 308 inner surfacies.Second guide rail 450 limits the first rail portion 450a of longitudinal extension basically, and from the circumferential intermediate orbit part 450b that extends of the far-end of the second guide rail 450b.On the identical direction of the direction of extending from the first rail portion 446a with intermediate orbit part 446b, intermediate orbit part 450b extends from the first rail portion 450a.

The first rail portion 446a and 450a limit first stroke of plunger 316 motions, make push rod 330 that second anchor log is ejected from ejecting port 442.Intermediate orbit part 446ba and 450b are configured to make plunger to rotate, in order to the 5th ways is alignd with second rail portion, this second rail portion is from the first rail portion 446a and 450a radial deflection.Particularly, shown in Figure 23 B, insert apparatus 330 and also comprise pair of holes 452, the contiguous centre bore 440 in this hole arranges, and longitudinal extension enters the distal surface 431 of the shaft portion 430 of plunger 416.Hole 452 is corresponding to be configured to hold corresponding the 5th ways and the 6th ways, described the 5th ways is configured to guide pillar 454(Figure 23 D of distad extending from plunger 416), described the 6th ways is depicted as in the inside 328 that is arranged on housing 308 and is fixed to guiding shell 460(Figure 23 E of housing 308 with respect to translation).Guiding shell 460 limits the 7th ways of second pilot pin 461 that is configured to extend radially outwardly, and this second pilot pin 461 is configured to take in second guide rail 450.Guiding shell 460 also limits the ways of the form that adopts at least one hole (for example longitudinal extension passes the pair of holes of guiding shell 460) and limits second rail portion 462.The size of second rail portion 462 is configured to hold guide pillar 454.The near-end of guiding shell 460 can limit a pair of groove 464, and described groove enters at the position longitudinal extension that is close to second rail portion 462 but do not pass guiding shell 460.Groove 464 can be arc, or alternatively as required by molding.

Referring now to Figure 23 A and Figure 23 F,, the distally bias force can be applied to plunger 316, make plunger 316 and push rod 330 with respect to housing 308 and therefore with respect to intubate 310 and guiding shell 460 along the distad translation of first stroke.Plunger 316 moves to the second position shown in Figure 23 F from the primary importance shown in Figure 23 A.When plunger 316 distad moved to the second position from primary importance, first pilot pin 448 alignd with the intermediate orbit part 446b of first guide rail 446 up to first pilot pin 448 along the first distad translation of rail portion 446a of first guide rail 446.Equally, when plunger 316 distad moved to the second position from primary importance, second pilot pin 461 alignd with the intermediate orbit part 450b of second guide rail 450 up to second pilot pin 461 along the first distad translation of rail portion 450a of second guide rail 450.In case plunger 316 has moved to the second position, guide pillar 454 is just from corresponding second rail portion, 462 circumferential offset, and for example in groove 464 in abutting connection with guiding shell 460.

Referring now to Figure 23 G,, plunger 316 can be along the direction rotation of arrow 456, first pilot pin 448 and second pilot pin 461 are advanced in corresponding intermediate orbit part 446b and 450b, up to the end that arrives intermediate orbit part 446b and 450b, the end of described intermediate orbit part limits corresponding stop part, described stop part prevents that plunger 316 from continuing with respect to housing 308 rotations, and prevents that further guide pillar 454 is with respect to 460 rotations of guiding shell.In case plunger 316 has finished rotation, guide pillar 454 just aligns with second rail portion 462.Therefore, shown in Figure 23 H, plunger 316 also can distad move to the 3rd position along second stroke from the second position, and at this moment, plunger 316 adjacency guiding shells 460 also are prevented from distad further advancing.Therefore, guiding shell 460 limit prevent plunger 316 distad translation exceed the stop part of the 3rd position.

When plunger 316 during along the second stroke translation, push rod 330 distad translation in the passage 312 of intubate 310, and the first anchor log main body 28a ejected from ejecting port 442.Each anchor log main body 28a and 28b ejected from apparatus to anatomical structure 24(referring to Figure 1A) after the position at rear, actuation force can be applied to each anchor log main body 28a and 28b.For example, insert the maintenance assembly that apparatus 330 can comprise type mentioned above, for example keep assembly 390 or any suitable otherwise maintenance assembly of structure.Alternatively, user can manually be applied to actuation force corresponding actuating strand 131a and 131b.Connector members can adopt mode mentioned above will activate strand 131a and 131b is attached at together then.

Now totally referring to Figure 24 A-25D, be to be understood that, insert apparatus and can be configured to have first intubate and second intubate and the first pusher assembly and the second pusher assembly, described first intubate and second intubate are to be orientated side by side by housings support, and keep the first anchor log main body and the second anchor log main body, the described first pusher assembly is operationally related with first intubate and second intubate respectively with the second pusher assembly, in order to the first anchor log main body and the second anchor log main body are ejected from corresponding first intubate and second intubate.What may expect is to guarantee that required intubate (the anchor log main body is about to from its ejection) is arranged on the distally with respect to another intubate, makes required intubate can insert following tissue, and does not need also to insert another intubate.

Shown in Figure 24 A, insert apparatus 300 and comprise housing 308, this housing comprises main part 308a and from the outward extending shank part of main part 308a 308b.Insert apparatus 300 and also comprise from housing 308 and be in particular the first intubate 310a that distad extends from main part 308a, and in the position of the contiguous first intubate 310a from housing 308 and be in particular the second intubate 310b that distad extends from main part 308a.The first intubate 310a and the second intubate 310b can extend parallel to each other as shown in the figure basically.Therefore, the first intubate 310a can be described to into side by side relationship with the second intubate 310b.The first intubate 310a and the second intubate 310b can limit corresponding vertically elongated passageway 312a and 312b, and described vertical elongated passageway keeps the corresponding first anchor log main body 28a and the second anchor log main body 28b.

Insert apparatus 300 and also can comprise respectively the first pusher assembly 317a and the second pusher assembly 317b that operationally is associated with the first intubate 310a and the second intubate 310b.Therefore, the first pusher assembly 317a is configured to the first anchor log main body 28a is ejected from the first intubate 310a, and the second pusher assembly 317b is configured to the second anchor log main body 28b is ejected from the second intubate 310b.The first intubate 310a and the second intubate 310b can limit the corresponding first cone point 311a and the second cone point 311b, and longitudinal extension passes first distally ejection port and second distally ejection port of corresponding most advanced and sophisticated 311a and 311b.

Among the first pusher assembly 317a and the second pusher assembly 317b each comprises the first plunger 316a and the second plunger 316b respectively, also comprises the first push rod 330a and the second push rod 330b that distad extend from plunger 316a and the 316b of correspondence respectively.Among plunger 316a and the 316b each limits corresponding shaft portion 430a and 430b and corresponding end cap, and described end cap can limit the first grip portion 432a and the second grip portion 432b that extends radially outwardly from the near-end of respective shaft part 430 and 430b.When the first plunger 316a and the second plunger 316b were positioned at their corresponding primary importances, the first grip portion 432a and the second grip portion 432b were spaced apart at nearside and housing 308.Insert apparatus 300 and also can comprise the first locking tab 468a and the second locking tab 468b that removably is attached to the first plunger 316a and the second plunger 316b.For example, in accordance with the embodiments illustrated, the first locking tab 468a and the second locking tab 468b are attached to corresponding the first axle part between the grip portion 432a of correspondence and the position between 432b and the housing 308 in the vertical and divide 430a and the second axle part to divide 430b.Therefore, the first locking tab 468a and the second locking tab 468b disturb corresponding grip portion 432a and 432b, and preventing that plunger 316 from distad moving to a degree of depth with respect to housing 308, this degree of depth will make the corresponding first anchor log main body 28a and the second anchor log main body 28b eject.

Insert the exchange actuator 470 that apparatus 330 also can comprise the trigger form, this exchange actuator extends partially into housing 308, and can stretch out from shank part 308b.Exchange actuator 470 is configured to move to actuated position from primary importance, so that the relative position of the reverse first most advanced and sophisticated 311a and the second most advanced and sophisticated 311b.Exchange actuator 470 can be attached to the first pusher assembly 317a, makes the nearside translation of actuator 470 cause the first pusher assembly 317a(to comprise the first plunger 316a and the first intubate 310a) the proximad translation.Shown in Figure 24 A, the first most advanced and sophisticated 311a of the first intubate 310a is arranged on the distally with respect to the second most advanced and sophisticated 311b of the second intubate 310b.In addition, the far-end of the second push rod 330b can stretch out a little from the corresponding second most advanced and sophisticated 311b, makes that the fore-and-aft distance between the far-end of the far-end of the second push rod 330b and the first most advanced and sophisticated 311a limits the insertion depth that enters following tissue.Except as otherwise noted, otherwise the second push rod 330b organizes the limited depth stop part below can inserting at the first most advanced and sophisticated 311a.Therefore it should be understood that the first most advanced and sophisticated 311a for example in the tissue below the first target anatomical position 24a place (referring to Figure 1A) is launched into, and the second most advanced and sophisticated 311b is launched in the following tissue.As described in greater detail below, exchange actuator 470 is actuated into the second position from primary importance makes the first most advanced and sophisticated 311a with respect to housing 308 and the second most advanced and sophisticated 311b proximal motion, make the second most advanced and sophisticated 311b can be for example at the second target anatomical position 24b(referring to Figure 1B) in the tissue below locating to be launched into, and the first most advanced and sophisticated 311a is launched in the following tissue.

During operation, referring to Figure 24 B, the first locking tab 468a can remove from the first plunger 316a, makes the plunger 316a that wins distad march to the second position shown in Figure 24 C from the primary importance shown in Figure 24 A with respect to housing 308, and the first grip portion 432a is thus in abutting connection with housing 308.But because the first push rod 330a translation be fixed to the first plunger 316a, so the distally translation of the first plunger 316a makes first push rod 330a translation in the first intubate 310a equally.The first push rod 330a makes the distally translation of the push rod 330a that wins that the first anchor log main body 28a is ejected from the first ejection port in abutting connection with the first anchor log main body 28a, for example enters the first target anatomical position.

Next referring to Figure 24 D, the second locking tab 468b can be removed from the second plunger 316b, shown in Figure 24 D.Referring to Figure 24 E, exchange actuator 470 can activated, but proximal motion for example with the first most advanced and sophisticated 311a that withdraws with respect to the second intubate 310b proximad, is arranged on nearside up to the first most advanced and sophisticated 311a with respect to the second most advanced and sophisticated 311b.In addition, the far-end of the first push rod 330a can stretch out a little from the corresponding first most advanced and sophisticated 311a, makes fore-and-aft distance between the far-end of the far-end of the push rod 330a that wins and the second most advanced and sophisticated 311b limit the second most advanced and sophisticated 311b and enters the insertion depth of following anatomical structure.Except as otherwise noted, otherwise the first push rod 330a organizes the limited depth stop part below can inserting at the second most advanced and sophisticated 311a.Therefore it should be understood that the second most advanced and sophisticated 311b for example in the tissue below the second target anatomical position 24b place (referring to Figure 1A) is launched into, and the first most advanced and sophisticated 311a is launched in the following tissue.In accordance with the embodiments illustrated, the actuating of exchange actuator 470 also makes the first plunger 316a proximad move to the primary importance shown in Figure 24 A.

Referring now to Figure 24 F,, the second plunger 316b can distad march to the second position shown in Figure 24 F from the primary importance shown in Figure 24 E with respect to housing 308, and the second grip portion 432b is thus in abutting connection with housing 308.But because the second push rod 330b translation be fixed to the second plunger 316b, so the distally translation of the second plunger 316b makes second push rod 330b translation in the second intubate 310b equally, eject and enter the second target anatomical position thereby make the second anchor log main body 28b eject port 442b from second.

To specifically further describe the operation of the insertion apparatus 300 shown in Figure 24 A-25D referring to Figure 25 A-D now.Particularly, insert apparatus 300 and comprise at least one latch assembly, for example the first latch assembly 305a, the second latch assembly 305b and the 3rd latch assembly 305c.In case the first latch assembly 305a be configured to the exchange actuator 470 from the primary importance proximal motion shown in Figure 24 D to second groove location shown in Figure 24 E, just will exchange actuator 470 and be locked in its proximal position.For example, first latch assembly 305 can comprise the latch member 307 that is supported by housing 308, this latch member is extended towards nearside abutment surface 307a proximad, be positioned at its second proximal position just in abutting connection with exchange actuator 470 in case this nearside abutment surface is configured to exchange actuator 470, thereby disturb exchange actuator 470 with respect to the distal movement of housing 308.When exchange actuator 470 proximal motion, latch member 307 can be away from exchange actuator 470 to intrinsic deflection, to allow exchange member 470 with respect to the nearside translation of latch member 307.In case exchange actuator 470 moves to its second proximal position with respect to housing 308 from its first initial position, just outwards motion under its spring force of latch member 307, make nearside abutment surface 307a in abutting connection with the exchange actuator 470, and prevent from exchanging actuator 407 from its second position with respect to housing 308 distal motion.

The second latch assembly 305b comprises by exchange actuator 470 carrying and can be with first latch member 347 of exchange actuator 470 motions, and by first plunger 316a carrying and second latch member 349 that can move with the first plunger 316a.First latch member 347 is attached to the first intubate 310a, makes the latch member 347 of winning cause the first intubate 310a with 470 translations of exchange actuator.Second latch member 349 comprises main body 349a, be positioned at first attachment part suspension hook for example of the far-end of main body 349a, and second attachment part abutment surface (second latch member 349 can be constructed to the mirror image of second latch member 353 of the 3rd latch assembly 305c hereinafter described) for example that is positioned at the proximal end of main body.Therefore, when the first plunger 316a moves to its second position shown in Figure 24 B from its primary importance shown in Figure 24 A, suspension hook away from first latch member to intrinsic deflection and along and take through first latch member 347.In case the first plunger 316a is positioned at its second position shown in Figure 24 B the anchor log main body 28a that wins is ejected, the just outwards motion under its spring force of the suspension hook of second latch member 349, make suspension hook be arranged on the distally of first latch member 347, and the abutment surface of second latch member is arranged on the nearside of first latch member 347.Therefore, first latch member 347 is trapped between the abutment surface of the suspension hook of second latch member 349 and second latch member 349.Like this, first latch member and second latch member 349 connect with respect to translation.

Therefore, in case the first anchor log main body 28a ejects from the first intubate 310a, second latch member 349 just is attached to first latch member 347, but this just with the first plunger 316a with respect to translation and translation ground is attached to and exchanges actuator 470.In addition, because first latch member 347 is by 470 carryings of exchange actuator and be attached to the first intubate 310a, so the motion of exchange actuator 470 proximads causes the first intubate 310a and first plunger, 316 equal proximal motion to positions, in this position, the first most advanced and sophisticated 311a and the first push rod 330a are arranged on nearside with respect to the second most advanced and sophisticated 311b, and the first push rod 330a then keeps being arranged on the distally of the first most advanced and sophisticated 311a.In addition, because the first plunger 316a is attached to exchange actuator 470 with respect to proximad and relative translation distad, again because exchange actuator 470 is attached to housing 308 with respect to nearside translation at least, so in case the first anchor log main body 28a ejects, prevented that just first plunger 316 is with respect to housing 308 proximad translations.Therefore can be the aforesaid second most advanced and sophisticated 311b provides the insertion depth stop part to the first push rod 330a.

The 3rd latch assembly 305c comprises first latch member 351 by housing 308 carrying, and by second latch member 353 of second plunger 316b carrying.Second latch member 353 comprises main body 353a, be positioned at the first attachment part 353b suspension hook for example of the far-end of main body 353a, and the second attachment part 353c abutment surface for example that is arranged on the proximal end of main body 353a.When the second plunger 316b distad moves to its second distal position shown in Figure 28 b from its primary importance shown in Figure 24 E, for example when ejecting the second anchor log main body 28b, suspension hook can be away from first latch member 351 to intrinsic deflection, and take along first latch member 351, and motion is through first latch member 351.In case the second plunger 316b is positioned at its second position shown in Figure 24 F, make that the second anchor log main body 28 is ejected, the suspension hook of second latch member 353 just outwards moves in the position in first latch member, 351 distally under its spring force, and the abutment surface of second latch member 353 is arranged on the nearside of first latch member 351.Therefore, first latch member 351 is trapped between the abutment surface of the suspension hook of second latch member 353 and second latch member 353.Therefore, in case the second anchor log main body 28b ejects, just prevent the second plunger 316b with respect to housing 308 proximads or distal motion, and the blunt far-end of the second push rod 330b remains on the distally of the second most advanced and sophisticated 311b.

In case anchor log main body 28a and 28b eject, just tension force can be applied to actuation part 131a and 131b(referring to Figure 1A), in order to described mode above anchor log main body 28a and 28b are expanded.For example, the first tensioning strand 380a and the second tensioning strand 380b(are referring to Figure 18 A-18B) can be attached between corresponding actuation part 131a and 131b and corresponding locking tab 468a and the 468b.Therefore, remove from corresponding plunger 316a and 316b at locking tab 468a and 468b, and after the corresponding first anchor log main body 28a and the second anchor log main body 28b have ejected, locking tab 468a and 468b cause tension force to be applied to corresponding tensioning strand 380a and 380b with respect to the proximal movement of anchor log main body 28a and 28b, and described tensioning strand is conveyed to actuation part 131a and 131b with this tension force in order to make anchor log main body 28a and 28b expands.Alternatively, tensioning strand 380a and 380b can be fixed in the housing 308 with any way mentioned above.

Referring now to Figure 26 A-B,, insert apparatus 300 and can comprise the maintenance assembly 490 of constructing according to alternative embodiment, this maintenance assembly is configured to that actuation force is applied to the first actuating strand 38a and second and activates strand 38b(referring to Figure 1A).For example, keep assembly 490 can directly keep first to activate strand 38a and the second actuating strand 38b.In accordance with the embodiments illustrated, for example under attachment part 133a and 133b are being loaded in when inserting in the apparatus 300 not by attached situation, keep assembly 490 to keep actuation part 131a and 131b and attachment part 133a and the 133b of the first anchor log main body 28a and the second anchor log main body 28b respectively.Perhaps, if attachment part 133a and 133b are being loaded in when inserting in the apparatus 300 attachedly in advance each other, then keep assembly only can keep actuation part 131a and 131b.Perhaps, as mentioned above, at least one tensioning strand can pass first respectively and activate strand 38 and second and activate strand 38b and sew up, and can remain on and keep in the assembly 490.No matter configuration why, keeps assembly all can be configured to actuation force is applied to and activate strand 38a and 38b, so that corresponding anchor log main body 28a and 28b move to its expanded configuration.

In accordance with the embodiments illustrated, keep assembly 490 can be mounted to any one or both in the intubate, for example first intubate 310a shown in Figure 26 A.Keep assembly 490 can comprise first locking component, for example be mounted to the first intubate 310a and be limited to the side direction strand that wherein extends and hold the maintenance shell 492 in gap 493.Particularly, keep shell to comprise first or nearside housing parts 492a and second or distally housing parts 492b, make gap 493 be arranged between the first housing parts 492a and the second housing parts 492b.Keep assembly 490 also can comprise second locking component, for example can be mounted to threadably keep shell 492(for example being mounted to the first housing parts 492a with 493 positions aligning places, gap) clamp 494.Clamp 494 makes clamp 494 enter gap 493 towards the second housing parts 492b translation with respect to the rotation that keeps shell 492 along first direction.Clamp 494 is with respect to keeping the rotation of shell 492 on the second direction relative with first direction to make clamp 494 translations go out gap 493 and away from the second housing parts 492b.

Therefore, during operation, one or more target strand 379, for example one or more actuating strand 38a and 38b or at least one tensioning strand can be loaded in the gap 493, and clamp 494 can rotate along first direction, up to keeping assembly 490 to catch target strand 379 between the far-end of clamp 494 and the second housing parts 492b.In case the first anchor log main body 28a and the second anchor log main body 28b have been ejected into the corresponding first target anatomical position and the second target anatomical position (referring to Figure 1A), inserting apparatus just can be away from the translation of anatomical position proximad, thereby actuation force is applied to first directly or indirectly activates strand 38a and the second actuating strand 38b, thereby anchor log main body 28a and 28b are actuated to its expanded configuration.Clamp 494 can rotate to increase gap 493 along second direction then, up to making it shake off target strand 379 with inserting apparatus 300 tractives.Alternatively or in addition, for example when target strand 379 is provided as the tensioning strand, described tensioning strand can be cut off when keeping in the assembly 490 being trapped in.Because intubate 310a and 310b can limit vertical slit of a side that extends through intubate 310a and 310b, so when corresponding anchor log main body 28a and 28b ejected from intubate, activating strand 38a and 38b can for example shake off corresponding intubate from vertical slit.

Now totally referring to Figure 27 A-28B, insert apparatus 300 and can be configured to have the first intubate 310a and the second intubate 310b and the first pusher assembly 317a and the second pusher assembly 317b, the described first intubate 310a and the second intubate 310b support to be orientated side by side by housing 308, and keep the first anchor log main body 28a and the second anchor log main body 28b, the described first pusher assembly 317a is operationally related with the first intubate 310a and the second intubate 310b respectively with the second pusher assembly 317b, in order to the first anchor log main body 28a and the second anchor log main body 28b are ejected from the corresponding first intubate 310a and the second intubate 310b.In addition, as mentioned above, may expect to guarantee that required intubate (the anchor log main body will eject from it) is arranged on the distally with respect to another intubate, make required intubate can insert following tissue, and do not need also to insert another intubate.

Shown in Figure 27 A, insert apparatus 300 and comprise housing 308, this housing comprises main part 308a and from the outward extending shank part of main part 308a 308b.Inserting apparatus 300 also comprises from housing 308, and the first intubate 310a that distad extends from main part 308a particularly, and in the position of the contiguous first intubate 310a from housing 308, and the second intubate 310b that distad extends from main part 308a particularly.The first intubate 310a and the second intubate 310b can extend parallel to each other as shown in the figure basically.Therefore, the first intubate 310a can be described to into side by side relationship with the second intubate 310b.The first intubate 310a and the second intubate 310b can limit corresponding vertically elongated passageway 312a and 312b, and described vertical elongated passageway keeps the corresponding first anchor log main body 28a and the second anchor log main body 28b.

Insert apparatus 300 and also can comprise respectively the first pusher assembly 317a and the second pusher assembly 317b that operationally is associated with the first intubate 310a and the second intubate 310b.Therefore, the first pusher assembly 317a is configured to the first anchor log main body 28a is ejected from the first intubate 310a, and the second pusher assembly 317b is configured to the second anchor log main body 28b is ejected from the second intubate 310b.The first intubate 310a and the second intubate 310b can limit the corresponding first cone point 311a and the second cone point 311b, and longitudinal extension passes first distally ejection port 442a and second distally ejection port 442b of corresponding most advanced and sophisticated 311a and 311b.

Among the first pusher assembly 317a and the second pusher assembly 317b each comprises respectively from housing 308, for example the outward extending first plunger 316a of the main part 308a of housing 308 and the second plunger 316b.The first plunger 316a and the second plunger 316b can extend housing 308 about the described proximad of Figure 24 A-F as mentioned, or can extend housing along the direction that is offset with respect to vertical L angledly, in order to present corresponding contact pin 323a and the 323b that outwards gives prominence to from housing 308.Among the first pusher assembly 317a and the second pusher assembly 317b each also can comprise the first push rod 330a and the second push rod 330b that distad extends from corresponding plunger 316a and 316b respectively.When the first plunger 316a and the second plunger 316b are in their corresponding primary importances (Figure 27 A), the first anchor log main body 28a and the second anchor log main body 28b are arranged among corresponding intubate 310a and the 310b.Plunger 316a and 316b are moveable to the corresponding second position (Figure 27 D), in order to the corresponding first anchor log main body 28a and the second anchor log main body 28b are ejected corresponding intubate 310a and 310b.

Insert apparatus 330 and also can comprise exchange actuator 470, exchange actuator 470 can comprise from housing 308 outward extending exchange contact pin 470a, and can extend out from main part 308a the position between the first contact pin 323a and the second contact pin 323b.Housing 308 can limit the upper end that extends through main part 308 and elongated slit 367a-c in the vertical, this slit is positioned such that the first contact pin 323a and the second contact pin 323b extend from the first slit 367a and the second slit 367b, and the 3rd slit 367c is extended in the position of exchange contact pin 470a between the first contact pin 323a and the second contact pin 323b.Therefore slit 367a-c can provide track, and when contact pin 323a-b and 470a took in corresponding slit 367a-c, described track limited the lengthwise movement of the first pusher assembly 317a and the second pusher assembly 317b and exchange actuator 470.Exchange actuator 470 is configured to move to actuated position from primary importance, so that the relative position of the reverse first most advanced and sophisticated 311a and the second most advanced and sophisticated 311b.For example, as shown in Figure 27 A, the first most advanced and sophisticated 311a of the first intubate 310a is arranged on the distally with respect to the second most advanced and sophisticated 311b of the second intubate 310b.Therefore it should be understood that the first most advanced and sophisticated 311a for example in the tissue below the first target anatomical position 24a place (referring to Figure 1A) is launched into, and the second most advanced and sophisticated 311b is launched in the following tissue.As described in greater detail below, (Figure 27 A) makes the second most advanced and sophisticated 311b with respect to the first most advanced and sophisticated 311a distal motion to the actuating of the second position (Figure 27 C) to exchange actuator 470 along the direction of arrow 355 from primary importance, make the second most advanced and sophisticated 311b for example in the tissue below the second target anatomical position 24b place (referring to Figure 1B) is launched into, and the first most advanced and sophisticated 311a is launched in the following tissue.

During operation, referring to Figure 27 A-B, the first plunger 316a can distad move to the second position along the direction of arrow 357 from primary importance, and this makes the push rod 330a distad translation in the first intubate 310a equally of winning.When the first push rod 300a distad moved to the second position, the first push rod 330a made the push rod 330a that wins that the first anchor log main body 28a is ejected from the first intubate 310a in abutting connection with the first anchor log main body 28a, for example enters the first target anatomical position.When the first pusher assembly 317a is positioned at the second position that the first anchor log main body 28 ejected, the first plunger contact pin 323a at the far-end of the first slit 367a in abutting connection with housing 308.Therefore, when the first plunger contact pin 323a was positioned at the second position, plunger 316a was prevented from further distad translation.Therefore, tactile feedback is provided for user, indicates the first anchor log main body 28a to eject.

Next, referring to Figure 27 C, exchange actuator 470 can activated, for example can be along the direction of arrow 355 from the primary importance distal motion to actuated position, make the second most advanced and sophisticated 311b advance or distad translation with respect to housing 308 and the first intubate 310a, be arranged on the distally up to the second most advanced and sophisticated 311b with respect to the first most advanced and sophisticated 311a.Therefore it should be understood that the second most advanced and sophisticated 311b for example in the tissue below the second target anatomical position 24b place (referring to Figure 1A) is launched into, and the first most advanced and sophisticated 311a is launched in the following tissue.For example, the far-end that is arranged on the first push rod 330a in distally with respect to the first most advanced and sophisticated 311a can be the second most advanced and sophisticated 311b and inserts the second target anatomical position depth stop spare is provided.Therefore, the second most advanced and sophisticated 311b can be launched into, up to the first push rod 330a in abutting connection with anatomical structure.In accordance with the embodiments illustrated, the actuating of exchange actuator 470 also makes the second plunger 316b, and and then the second push rod 330b distad translation shown in Figure 27 C.In case exchange actuator 470 has been moved to actuated position, exchange contact pin 470a just at the far-end of the 3rd slit 367c in abutting connection with housing 308, to prevent from exchanging further distad translation of actuator 470.Therefore, tactile feedback is provided for user, and indication exchange actuator 470 has activated.

Referring now to Figure 27 D,, the second plunger 316b can distad move to the second position along the direction of arrow 359 from primary importance, and this makes the second push rod 330b distad translation in the second intubate 310b equally.When the second push rod 300b distad moved to the second position, the second push rod 330b made the second push rod 330b that the second anchor log main body 28b is ejected from the second intubate 330b in abutting connection with the second anchor log main body 28b, for example enters the second target anatomical position.When the second pusher assembly 317b is positioned at the second position that the second anchor log main body 28b ejected, the second plunger contact pin 323b at the far-end of the second slit 367b in abutting connection with housing 308.Therefore, when plunger contact pin 323b was positioned at the second position, plunger 316b was prevented from further distad translation.Therefore, tactile feedback is provided for user, indicates the second anchor log main body 28b to eject.

To specifically further describe the operation of the insertion apparatus 300 shown in Figure 27 A-28B referring to Figure 28 A-B now.Particularly, insert apparatus 300 and comprise at least one latch assembly, for example first latch assembly 482, second latch assembly 484 and the 3rd latch assembly 486.In case first latch assembly 482 be configured to the exchange actuator 470 from the primary importance distal motion shown in Figure 27 B to second groove location shown in Figure 27 C, just will exchange actuator 470 and be locked in its distal position.For example, first latch assembly 482 can comprise latch member 488, and this latch member is supported by housing 308, and is configured to be latchable on the exchange actuator 470, in order to be attached to exchange actuator 470 with respect to translation.Latch member 488 limits main body 488a, the first attachment part 488b and the second attachment part 488c, the first attachment part 488b is the form by the suspension hook of main body 488a carrying, and the second attachment part 488c is the form by the abutment surface in main body 488a distally carrying, that be arranged on the first attachment part 488b.When exchange actuator 470 distal motion, the first attachment part 488a can in order to allow exchange member 470 with respect to latch member 488, for example exchange the outwards outstanding distad translation of contact pin 470a of actuator 470 away from exchange actuator 470 to intrinsic deflection.In case exchange actuator 470 moves to its second distal position from its first initial position with respect to housing 308, exchange actuator 470 just contacts abutment surface, and suspension hook can be to extrinsic deflection under the spring force of main body 488a, make exchange actuator 470 for example contact pin 470a become and be trapped between the first attachment part 488b and the second attachment part 488c.Therefore, in case exchange actuator 470 has moved to its proximal position the second pusher assembly 317b is distad advanced with respect to the first pusher assembly 316a, latch member 488 just prevents from exchanging actuator 470 with respect to housing proximad and distal motion.

Insert apparatus 300 and also can comprise at least one first ways 483a, but for example be fixed to translation the lead of housing 308.For example, insert apparatus 300 and can comprise the base 485 that supports and be attached to the first ways 483a by housing 308.First ways, 483 extensible passing exchange actuator 470, so that the distad translation of guiding exchange actuator.

In case second latch assembly 484 makes the first push rod 330a that the first anchor log main body 28a is ejected from the primary importance distal motion shown in Figure 27 A to second distal position shown in Figure 27 B, second latch assembly 484 just be configured to the first plunger 316a and and then the first pusher assembly 317a be locked in its proximal position.For example, second latch assembly 484 can comprise latch member 489, and this latch member is supported by housing 308 and is configured to be latchable on the first plunger 316a, in order to be attached to the first plunger 316a with respect to translation.Second latch member 489 can be constructed with respect to first latch member 488 substantially the samely, therefore and limit main body, first attachment part and second attachment part, described first attachment part is the form by the suspension hook of main body carrying, and described second attachment part is for being carried and be arranged on the form of the abutment surface in suspension hook distally by main body.When the first plunger 316a distal motion, first attachment part can be away from the first plunger 316a to intrinsic deflection, in order to allow the first plunger 316a with respect to second latch member 489, for example the outwards outstanding contact pin 316c of the first plunger 316a is sent to the distally translation.In case the first plunger 316a moves to its second distal position from its first initial position with respect to housing 308, the first plunger 316a just contacts abutment surface, and suspension hook can be to extrinsic deflection under the spring force of latch member 489 main bodys, make win plunger 316a for example contact pin 316c become between first attachment part and second attachment part that is trapped in latch member 489.Therefore, in case first plunger 316 has moved to its distal position so that the first anchor log main body 28a is ejected from the first intubate 310a, latch member 489 prevents that just the first plunger 316a is with respect to housing 308 proximads and distal motion.

Insert apparatus 300 and also can comprise at least one second ways 483b, but for example be fixed to translation the lead of housing 308.For example, base 485 can be attached to the second ways 483b, and this second ways can distad extend through the first plunger 316a in order to guide the first distad translation of plunger 316a.

In case the 3rd latch assembly 486 makes the second push rod 330b that the second anchor log main body 28b is ejected from the primary importance distal motion shown in Figure 27 C to second distal position shown in Figure 27 D, the 3rd latch assembly 486 just be configured to the second plunger 316b and and then the second pusher assembly 317b be locked in its distal position.For example, the 3rd latch assembly 486 can comprise the 3rd latch member 495, the three latch member by housing 308 supports and be configured to be latchable on the second plunger 316b, in order to be attached to the second plunger 316b with respect to translation.The 3rd latch member 495 can be constructed with respect to first latch member 488 and second latch member 489 substantially the samely, therefore and limit main body 495a, the first attachment part 495b and the second attachment part 495c, the described first attachment part 495b is the form by the suspension hook of main body 495a carrying, and the described second attachment part 495c be the form of the abutment surface that carried by main body 495a in the position in suspension hook distally.When the second plunger 316b distal motion, the first attachment part 495b can be away from the second plunger 316b to intrinsic deflection, in order to allow the second plunger 316b with respect to the 3rd latch member 495, and for example outwards outstanding contact pin 316d proximad translation of the second plunger 316b.In case the second plunger 316b moves to its second proximal position from its first initial position with respect to housing 308, the second plunger 316b is just for example at contact pin 316d place contact abutment surface 495c, and suspension hook 495b can be to extrinsic deflection under the spring force of latch member bodies 495a, between first attachment part and second attachment part that makes the second plunger 316b become to be trapped in latch member 495.Therefore, in case the second plunger 316b has moved to its distal position so that the second anchor log main body 28b is ejected from the second intubate 310b, latch member 495 prevents that just the second plunger 316b is with respect to housing 308 proximads and distal motion.

Insert apparatus 300 and also can comprise at least one the 3rd ways 483c, but for example be fixed to translation the lead of housing 308.For example, base 485 can be attached to the 3rd ways 483c, and the 3rd ways can distad extend through the second plunger 316b in order to guide the second distad translation of plunger 316.In addition, insert apparatus 300 and can comprise attachment members 496, this attachment members is for being attached to the second plunger 316b form of the attachment wire of exchange actuator 470 with respect to the distally translation of exchange actuator 470.For example, the distally translation of exchange actuator 470 makes the second plunger 316b with the distad translation of exchange actuator 470.The distally power that is applied to the second plunger 316b can allow the second plunger 316b with respect to the distad translation of exchange actuator 470.According to an embodiment, but attachment members 496 can be fixed to translation exchange actuator 470, and can be attached to the second plunger 316b, make attachment members 496 with respect to the proximal movement 316b of the relative attachment members 493 of the second plunger 316b and disturb second plunger 316.Exchange actuator 470 can comprise the second contact pin 470b that is attached to the second intubate 310b with respect to translation, makes the distally translation of exchange actuator 470 make the second intubate 310b with the distad translation of exchange actuator 470.Therefore, the distally translation of exchange actuator 470 makes attachment members 496 distad pull the second plunger 316b, the second intubate 310b and the second push rod 330b, is arranged on the distally of the first most advanced and sophisticated 311a up to the second most advanced and sophisticated 311b.Because after the first anchor log main body 28a has ejected, the first push rod 330a keeps being arranged on the distally of the first most advanced and sophisticated 311a, so the far-end of the first push rod 330a can limit the insertion depth stop part at the second most advanced and sophisticated 311b with mode mentioned above.

Attachment members 496 can extend through the second plunger 496b at least in part, in order to allow the second plunger 496b with respect to attachment members 496 and and then also with respect to the distad translation of exchange actuator 470.Therefore, in case distad translation of exchange actuator 470, thereby also make the second intubate 310b and the second distad translation of pusher assembly 317b, the translation of the second plunger 316b just makes the second push rod 330b in described mode above the second anchor log main body 28b be ejected from the second intubate 310b.

Now totally referring to Figure 29 A-29G, insert apparatus 300 and can be configured to have the first intubate 310a and the second intubate 310b and the first pusher assembly 317a and the second pusher assembly 317b, the described first intubate 310a and the second intubate 310b support to be orientated side by side by housing 308, and keep the first anchor log main body 28a and the second anchor log main body 28b, the described first pusher assembly 317a is operationally related with the first intubate 310a and the second intubate 310b respectively with the second pusher assembly 317b, in order to the first anchor log main body 28a and the second anchor log main body 28b are ejected from the corresponding first intubate 310a and the second intubate 310b.In addition, as mentioned above, may expect to guarantee that required intubate (the anchor log main body is about to from its ejection) is arranged on the distally with respect to another intubate, make required intubate can insert following tissue, and do not need also to insert another intubate.

Shown in Figure 29 A, insert apparatus 300 and comprise housing 308, this housing comprises the second housing parts 308b that the first housing parts 308a and the contiguous first housing parts 308a arrange.Insert apparatus 300 and also comprise the first intubate 310a that distad extends from the first housing parts 308a, and the second intubate 310b that distad extends from the second housing parts 308b.The first housing parts 308a and the second housing parts 308b can extend parallel to each other as shown in the figure basically.Therefore, the first intubate 310a can be described to into side by side relationship with the second intubate 310b.The first intubate 310a and the second intubate 310b can limit corresponding vertically elongated passageway, and described vertical elongated passageway keeps the corresponding first anchor log main body 28a and the second anchor log main body 28b in described mode above.The first intubate 310a and the second intubate 310b also can comprise a side that extends into intubate and vertical elongated sides slit 337a and the 337b that is communicated with corresponding elongated passageway respectively.Therefore, when the first anchor log main body 28a and the second anchor log main body 28b are loaded among the corresponding first intubate 310a and the second intubate 310b, activate strand 38a and 38b attachment part 133a-b can from corresponding side slit 337a and 337b extends and be attached to one another (referring to Figure 1A).

Insert apparatus 300 and also can comprise respectively the first pusher assembly 317a and the second pusher assembly 317b that operationally is associated with the first intubate 310a and the second intubate 310b.Therefore, the first pusher assembly 317a is configured to the first anchor log main body 28a is ejected from the first intubate 310a, and the second pusher assembly 317b is configured to the second anchor log main body 28b is ejected from the second intubate 310b.The first intubate 310a and the second intubate 310b can limit the corresponding first cone point 311a and the second cone point 311b, and longitudinal extension passes first distally ejection port and second distally ejection port of corresponding most advanced and sophisticated 311a and 311b.

Among the first pusher assembly 317a and the second pusher assembly 317b each comprises the first plunger 316a and the second plunger 316b respectively, and the described first plunger 316a and the second plunger 316b are arranged on outside the corresponding first housing parts 308a and the second housing parts 308b in the position that is in nearside with respect to as shown in the figure housing parts 308a.Among the first pusher assembly 317a and the second pusher assembly 317b each also can comprise the first push rod 330a and the second push rod 330b respectively, the described first push rod 330a and the second push rod 330b distad extend from plunger 316a and the 316b of correspondence, pass the corresponding first housing parts 308a and the second housing parts 308b, and enter the corresponding first intubate 310a and the second intubate 310b.When the first plunger 316a and the second plunger 316b are in their corresponding primary importances (Figure 29 A), the first anchor log main body 28a and the second anchor log main body 28b are arranged among corresponding intubate 310a and the 310b.Plunger 316a and 316b are moveable to the corresponding second position (Figure 29 F), in order to the corresponding first anchor log main body 28a and the second anchor log main body 28b are ejected corresponding intubate 310a and 310b.

Insert apparatus 330 and also can comprise exchange actuator 470, this exchange actuator can comprise the exchange button 470a that extends laterally across the first housing parts 308a and enter the second housing parts 308b.Exchange actuator 470 is configured to optionally connect and break away from first housing parts and second housing parts with respect to the relative translation of L longitudinally.For example, shown in Figure 29 B and Figure 29 G, the first housing parts 308a and the second housing parts 308b can longitudinally connect slidably.For example, one of housing parts, for example the first housing parts 308a can limit the slit 375 that extends along at least a portion of its longitudinal length.Another housing parts, for example the second housing parts 308b can comprise for example protuberance 377 of slider component, this slider component is configured to take at slit inner in order to guide the first housing parts 308a and the second relative to each other lengthwise movement of housing parts 308b.Slit 375 and protuberance 377 can dovetail configuration angledly outwards open, and separate with the direction that vertical L is offset angledly with second housing parts 308b edge to prevent the first housing parts 308a.Exchange actuator 470 is configured to longitudinally the first housing parts 308a and the second housing parts 308b relative to each other be moved, and makes corresponding most advanced and sophisticated 311a move to second relative position relative with first relative position with 311b from first relative position.

For example, shown in Figure 29 A, the first most advanced and sophisticated 311a of the first intubate 310a can be arranged on the distally with respect to the second most advanced and sophisticated 311b of the second intubate 310b at first.Therefore it should be understood that for example tissue below the first target anatomical position 24a place (referring to Figure 1A) is launched into of the first most advanced and sophisticated 311a, and do not make the second most advanced and sophisticated 311b be launched into following tissue.As described in greater detail below, exchange actuator 470 is actuated into the second position from primary importance (Figure 29 D) makes the second most advanced and sophisticated 311b with respect to the first most advanced and sophisticated 311a distal motion, makes the second most advanced and sophisticated 311b be positioned at the distally of the first most advanced and sophisticated 311a.Therefore, the second most advanced and sophisticated 311b is the tissue below the second target anatomical position 24b place (referring to Figure 1B) is launched into for example, and does not make the first most advanced and sophisticated 311a be launched into following tissue.

During operation, referring to Figure 29 C, the first plunger 316a can distad move to the second position from primary importance, makes the push rod 330a distad translation in the first intubate 310a equally of winning.When the first push rod 300a distad moved to the second position, the first push rod 330a made the push rod 330a that wins that the first anchor log main body 28a is ejected from the first intubate 310a in abutting connection with the first anchor log main body 28a, for example enters the first target anatomical position.When the first pusher assembly 317a was positioned at the second position (the first anchor log main body 28a ejects thus), the first plunger 316a can be in abutting connection with the first housing parts 308a.Therefore, when the first plunger 316a was positioned at the second position, the first plunger 316a was prevented from further distad translation.Therefore, tactile feedback is provided for user, indicates the first anchor log main body 28a to eject.

Next, referring to Figure 29 C, 29D and 29G, exchange actuator 470 can activated, so that with the reverse relative position of the first most advanced and sophisticated 311a and the second most advanced and sophisticated 311b of aforesaid way.For example, exchange actuator 470 can comprise button 472, and this button extends laterally across the first housing parts 308a and enters the second housing parts 308b.The second housing parts 308b can comprise spring member 474, and this spring member is outwards setovered button 472 towards its primary importance.Button 472 can comprise at least one flange 476, and the wall of this flanges abut second housing parts 308b ejects button 472 with the power that prevents spring member 474 from the first housing parts 308a.

The first housing parts 308a can comprise pair of holes 478a-b, and the size in this hole is configured to hold button 472, makes button 472 extend the first housing parts 308a.The first hole 478a is arranged on nearside with respect to the second hole 478b.When button 472 extended through the first hole 478a, the first most advanced and sophisticated 311a was arranged on the distally with respect to the second most advanced and sophisticated 311b.In addition, the interference between button 472 and the first housing parts 308a prevents that the first housing parts 308a is with respect to the second housing parts 308b longitudinal translation.When button 472 be pressed in the slit 375 and and then when being pressed in the protuberance 377, the interference between button 472 and the first housing parts 308a is removed, and makes win housing parts 308a and the second housing parts 308b be configured to relative to each other longitudinal translation.For example, the second housing parts 308b and and then the second intubate 310b can with respect to the first housing parts 308a and and then the first intubate 310a distad slide, be driven through the second hole 478b shown in Figure 29 D up to button 472.When button 472 extended through the second hole 478b, the second most advanced and sophisticated 311b was arranged on the distally with respect to the first most advanced and sophisticated 311a.Therefore it should be understood that for example tissue below the second target anatomical position 24b place (referring to Figure 1A) is launched into of the second most advanced and sophisticated 311b, and do not make the first most advanced and sophisticated 311a be launched into following tissue.

Referring now to Figure 29 D-E,, to insert apparatus 300 and also can comprise locking tab 468, this locking tab longitudinally removably is being attached to the second push rod 330b between the plunger 316b of correspondence and the position between the second housing parts 308b.Therefore, locking tab 468 disturbs plunger 316b distad to move to a degree of depth with respect to the second housing parts 308b, and this degree of depth will make the corresponding second anchor log main body 28b eject.Locking tab 468 can keep being attached to the second push rod 330b, has been ejected and has exchanged actuator 470 up to the first anchor log main body 28a and activated.Insert apparatus 300 and also can comprise the locking tab that operationally is associated with about the described mode of the second pusher assembly 317b and the first pusher assembly 317.

Referring now to Figure 29 E-F,, in case locking tab 468 is removed from second push rod 430, the second plunger 316b just can distad move to the second position from primary importance, and this makes the second push rod 330b distad translation in the second intubate 310b equally.When the second push rod 300b distad moved to the second position, the second push rod 330b made the second push rod 330b that the second anchor log main body 28b is ejected from the second intubate 330b in abutting connection with the second anchor log main body 28b, for example enters the second target anatomical position.After the second anchor log main body 28b has ejected, the grip portion 432b of the second plunger 416b at far-end in abutting connection with housing 308, thereby provide tactile feedback to user, indicate the second anchor log main body 28b to eject.

Now totally referring to Figure 30 A-D, insert apparatus 300 and can be configured to have the first intubate 310a and the second intubate 310b, described first intubate and second intubate support to be orientated side by side by housing 308, and keep the first anchor log main body and the second anchor log main body respectively.Among the first intubate 310a and the second intubate 310b each supports by housing 308, but so that can be with respect to the motion of housing 308 translations ground.Insert apparatus 300 and also comprise the reciprocating motion assembly 500 that is configured to drive in relative direction the first intubate 310a and the second intubate 310b.For example, when the first intubate 310a is distad driven with respect to housing 308, moves back and forth assembly 500 the second intubate 310b is driven with respect to housing 308 proximads.Similarly, when the first intubate 310a is driven with respect to housing 308 proximads, moves back and forth assembly 500 the second intubate 310b is distad driven with respect to housing 308.Similarly, when the second intubate 310b is distad driven with respect to housing 308, moves back and forth assembly 500 the first intubate 310a is driven with respect to housing 308 proximads.Similarly, when the second intubate 310b is driven with respect to housing 308 proximads, moves back and forth assembly 500 the first intubate 310a is distad driven with respect to housing 308.

Insert apparatus 300 and can comprise pusher assembly 317, this pusher assembly has plunger 316 and the first pusher member 330a and the second pusher member 330b.The first pusher member 330a extends into the first intubate 330a, and is configured in described mode above the first anchor log main body be ejected from the first intubate 330a.Similarly, the second pusher member 330b extends into the second intubate 330b and is configured to and in described mode above the second anchor log main body 28b ejected from the second intubate 330b.Insert apparatus and also can comprise selectivity plunger conjugative component 502, this selectivity plunger conjugative component is exercisable, in order to selectively plunger is bonded between one among the first push rod 330a and the second push rod 330b.Therefore, but plunger 316 can be attached to translation the first push rod 330a, makes the distally translation of plunger 316 cause distad translation and the first anchor log main body 28a ejected from the corresponding first intubate 330a of push rod 330a.But plunger 316 can be attached to translation the second push rod 330b, makes the distally translation of plunger 316 cause distad translation and the second anchor log main body 28b ejected from the corresponding first intubate 330b of push rod 330b.

Referring now to Figure 30 A-C,, move back and forth assembly 500 and comprise first force transmitting member, the jagged first tooth bar 504a for example, but this first tooth bar is fixed to the first intubate 310a with being attached to the first intubate 310a and translation.The first tooth bar 504a can be in aggregates with the first intubate 310a, or be attached to the first intubate 310a as required discretely.In accordance with the embodiments illustrated, the first tooth bar 504a extends from the first intubate 310a proximad.Move back and forth assembly 500 and also can comprise second force transmitting member, the second jagged tooth bar 504b for example, but this second tooth bar is fixed to the second intubate 310b with being attached to the second intubate 310b and translation.The second tooth bar 504b can be in aggregates with the second intubate 310b, or be attached to the second intubate 310b as required discretely.In accordance with the embodiments illustrated, the second tooth bar 504b extends from the second intubate 310b proximad.

Move back and forth assembly 500 and also can comprise the 3rd force transmitting member, the first gear 506a for example, this first gear can be spur gear, and this spur gear cooperates with first tooth bar, makes the rotation of the gear 506a that wins drive the first tooth bar 504a for example proximad or distad substantial linear ground translation.The first intubate 310a is with the first tooth bar 504a translation.Move back and forth assembly 500 and also can comprise the 4th force transmitting member, the second gear 506b for example, this second gear can be spur gear, and this spur gear cooperates with the second tooth bar 504b, makes the rotation of the second gear 506b drive the first tooth bar 504a for example proximad or distad substantial linear ground translation.The second intubate 310b is with the second tooth bar 504b translation.In addition, the first gear 506a and the second gear 506b cooperate, and the rotation on first direction of rotation drives the first gear 506a and rotates in second direction of rotation relative with first direction of rotation with another person among the second gear 506b with 508b along their corresponding rotating shaft 508a to make one among win gear 506a and the second gear 506b.The first gear 506a and the second gear 506b can be supported in the housing 308, make rotating shaft 508a and 508b keep static when gear 506a and 506b rotation.

The second tooth bar 504b can comprise the shank 508b that extends housing 308.During operation, for example when the first intubate 310a distad extended with respect to the second intubate 310b, shank 508b can be distad driven, and this makes the second intubate 310b and the second distad translation of tooth bar 504b, thereby rotates the second gear 506b along direction of rotation.The second gear 506b drives the first gear 506a along relative direction of rotation rotation, and this makes the intubate 310a that wins towards housing 308 proximad translations.Therefore, because the second intubate 310b is distad driven, move back and forth assembly just along relative direction, for example proximad drives the first intubate 310a as shown in the figure.

When the second intubate 310b distad extends with respect to the first intubate 310a, but shank 508b proximad is driven, and this makes the second intubate 310b and the second tooth bar 504b proximad translation, thereby rotates the second gear 506b along direction of rotation.The second gear 506b drives the first gear 506a along relative direction of rotation rotation, and this makes the intubate 310a that wins away from distad translation of housing 308.Therefore, because the second intubate 310b proximad is driven, move back and forth assembly just along relative direction, for example distad drive the first intubate 310a as shown in the figure.

Shank 508b can comprise suspension hook 510, and this suspension hook is latchable on the housing 308 in order to lock is provided, and this lock prevents that shank 508b from the distally translation taking place, and and then prevents that also the second tooth bar 504b from the distally translation taking place.Suspension hook 510 can be configured to be latchable on the housing 308 when the second intubate 310b withdraws, and the first intubate 310a distad extends with respect to the second intubate 310b and is arranged on the distally.

Referring now to Figure 30 C-D,, selectivity plunger conjugative component 502 comprises the track 512 by housing 308 carryings.Track 512 can extend radially outwardly and enter the inwall of housing 308.Track comprises the 512a of first, and this first basically longitudinally and be parallel to intubate 310a and 310b and push rod 330a and 330b and extend.Track also comprises second portion 512b, and this second portion is from the 512a of first, for example from the proximal extension of the 512a of first, and from the 512b of first proximad and outwards, for example side direction stretches out.Therefore we can say that second portion 512b is offset with respect to the 512a of first.In accordance with the embodiments illustrated, second portion 512b is offset with respect to the 512a of first angledly.

Plunger 316 is configured to take in track 512, and can be along track 512 distal motion, so that the first intubate 310a and the second intubate 310b corresponding one in distad drive optional among the first push rod 330a and the second push rod 330b, thereby corresponding one in first anchor log and second anchor log ejected the insertion apparatus.In accordance with the embodiments illustrated, the first push rod 330a and the second push rod 330b carry the first engagement member 514a and the second engagement member 514b.Engagement member 514a and 514b can be spaced apart from each other, in order to the gap is provided when the first intubate 310a and the second intubate 310b are back and forth driven.Should be appreciated that because the first push rod 330a and the second push rod 330b extend into the corresponding first intubate 310a and the second intubate 310b, so during the reciprocating motion of intubate 310a and 310b, push rod 330a and 330b are reciprocally driven equally.

Plunger 316 carrying biasing members 516, when plunger 316 was arranged among the first rail portion 512a, each among this biasing member 516 and engagement member 514a and the 514b was vertically alignd.Plunger 316 also carries driven member 518, and the size and dimension of this driven member is configured to take in track 512, and the travel path of guiding plunger 316 when driven in plunger proximad and distally.Plunger 316 can comprise near-end, and described near-end extends from housing 308, and for example proximad extends.Therefore, plunger 316 can be distad driven along the first rail portion 512a, and driven along the first rail portion 512a proximad.Plunger also can be driven along the second rail portion 512b proximad, and this makes biasing member 516 no longer vertically align with engagement member 514a and 514b.Therefore, intubate 310a and 310b and corresponding push rod 330a and 330b can reciprocally move, and meanwhile engagement member 514a and 514b are not interfering with each other, and engagement member 514a and 514b do not disturb the biasing member 516 of plunger 316 yet.

When expecting that for example the first intubate 310a ejects from corresponding intubate with one of anchor log main body, can be set to align with plunger 316 by the first push rod 330a.For example, moving back and forth assembly 500 can activated as required, in order to corresponding engagement member 514a is positioned at the near-end distally of the first rail portion 512a.Therefore, plunger 316 can be distad driven along track 512.In case plunger 512 is distad advanced along the first rail portion 512a, biasing member 516 just engages engagement member 514a, and distad drives push rod 330a in corresponding intubate 310a, thereby as mentioned above the anchor log main body is ejected from intubate 310a.

In case expectation is ejected the second anchor log main body from the second intubate 310b, but plunger 316 just proximad is driven on the second rail portion 512b, no longer vertically aligns with engagement member 514a and the 514b of the first push rod 330a and the second push rod 330b up to biasing member 516.Next, moving back and forth assembly 500 can activated, in order to distad drive the second intubate 310b and the second push rod 330b, this makes win intubate 310a and the first push rod 330a proximad translation, be arranged on the nearside of the first rail portion 512a near-end up to the first engagement member 514a, and the second engagement member 514b is arranged on the distally of the first rail portion 512a near-end.Therefore, the second intubate 310b is arranged on the distally with respect to the first intubate 310a.Next, plunger 316 can be distad driven, and this makes biasing member 516 engage the second engagement member 514b, and then distad drive the second push rod 330b in order to second anchor log is ejected the insertion apparatus in the second intubate 330b.

Referring now to Figure 31,, although being described to comprise the distally, various insertion apparatus 300 ejects port 442, insert apparatus 300 and side can be ejected the substitute that port 318 is defined as distally ejection port 442.For example, side ejects port 318 can be restricted to slit, and this slit is in the distal part that radially extends through intubate 310 with respect to most advanced and sophisticated 311 positions that are positioned at nearside.Most advanced and sophisticated 311 can be closed, ejects from ejecting port 442 by most advanced and sophisticated 311 distally that limit in order to prevent anchor log main body 28a and 28b.Side ejects port 318 can limit a circumferential size, this circumferential size is substantially equal to or at least greater than each cross-sectional dimension among the first anchor log main body 28a and the second anchor log main body 28b, makes the size of anchor log main body 28a and 28b be configured to advance to pass side to eject port 318.In addition, side ejects port 318 can limit a longitudinal length, and this longitudinal length is substantially equal to or greater than each longitudinal length among the first anchor log main body 28a and the second anchor log main body 28b.For example, if the first anchor log main body 28a and the second anchor log main body 28b are offset with respect to longitudinal axis 302 when ejecting port 318 from side and eject angledly, then the side longitudinal length that ejects port 318 can be slightly less than among the first anchor log main body 28a and the second anchor log main body 28b longitudinal length of each.

Most advanced and sophisticated 311 can limit slideway 372 in its proximal end.The side that therefore can be arranged on slideway 372 eject port 318 far-end and with longitudinal axis 302 substantial alignment.Slideway 372 can limit taper and eject surface 374, and it is radially outward angled towards side ejection port 318 when distad extending that the surface is ejected in this taper.Therefore, when along with plunger 316 and ejector sleeve 334 and collar 332 move to the second position from primary importance, plug 314 distad is biased to the second anchor log main body 28b when ejecting on the surface 374 from the elongated open 312 of intubate 310, the second anchor log main body 28b takes along ejecting surface 374, this just is guided out side with the second anchor log main body 28b along direction of arrow B and ejects port 318, thereby at the second target anatomical position 24b place the second anchor log main body 28b is ejected insertion apparatus 300(referring to Figure 1A).When the distal part at least of side ejection port 318 was arranged on anatomical structure 24 rears, the second anchor log main body 28b ejected from inserting apparatus 300 in the position at anatomical structure 24 rears, shown in Figure 1A is further.Insert apparatus 300 and can be configured to make that plug 314 is arranged on most advanced and sophisticated 311 nearside and adjacent most advanced and sophisticated 311 when push rod 330 and ejector sleeve 334 disengagings.Therefore, push rod 330 makes push rod in described mode above the first anchor log 28a be ejected port 318 from side along the slideway surface 378 of plug 314 with respect to the translation of ejector sleeve 334 to eject.

Referring now to Figure 32 A-M,, shows the exemplary embodiment that is configured to anchor log 22 is inserted the insertion apparatus 600 of target anatomical position 24.In accordance with the embodiments illustrated, target anatomical position 24 is bone, can be used for anchor log 22 is inserted any other suitable target anatomical position but insert apparatus 600, as described in other places of this paper.Illustrated insertion apparatus 600 can comprise parts, and described parts comprise and enter assembly 602 and/or anchor log inserter assembly 604.

Enter the target anatomical position 24 that assembly 602 can be used for preparing to supply at least one anchor log (for example a plurality of anchor logs 22) insertion, as described in greater detail below, and/or be used to one or more parts of anchor log inserter assembly 604 to provide to lead to for example a plurality of target anatomical positions 24 of at least one target anatomical position 24() path.Enter assembly 602 and can comprise that entering member 606 and opening forms member 608, described opening forms member 608 and is configured to be arranged on and enters in the member 606, for example illustrated awl 609.

Illustrated enter member 606 longitudinally L be elongated, and be included in extend between near-end 610a and the relative far-end 610b enter member body 610, it can limit the far-end 610b that inserts apparatus 600.In this, except as otherwise noted, otherwise can be reference to the far-end that inserts apparatus 600 equally to the reference of far-end 610b.Enter that member 606 limits longitudinally axis or central axis C extends through this intubate that enters member 606 612.The size of intubate 612 can be set at least a portion that can hold awl 609 therein, make that entering member 606 is configured to carry described awl 609.For example, intubate 612 can limit diameter D1, and this diameter is a bit larger tham the D outer diameter 2 of the complementary portion of awl 609.

In accordance with the embodiments illustrated, entering member body 610 can be two parts main body, and described two parts main body comprises having relative near-end 614a and the tubular portion 614 of far-end 614b, and the clamper part 616 with relative near-end 616a and far-end 616b.Clamper part 616 can limit external diameter, and this external diameter is greater than the external diameter of tubular portion 614.Clamper part 616 also can limit at least one axial bore that extends into the clamper part, for example a plurality of axial bore.For example, but 616 clampings of clamper part limit the first bore hole 616c that extends into clamper part 616 from the far-end 616b of clamper part 616, and the size of this first bore hole is configured to and tubular portion 614 can be fixed to clamper part 616.Randomly, clamper part 616 also can limit the second bore hole 616d that extends into clamper part 616 from the near-end 616a of clamper part 616, the size of this second bore hole is configured to hold alternative embodiment of the anchor log shell 634 of sleeve pipe 660 forms, and is as described in greater detail below.

The near-end 614a of tubular portion 614 can cave among the far-end 616b of clamper part 616 at least in part.For example, clamper part 616 can be overmolded onto on the tubular portion 614.Perhaps, tubular portion 614 can be attached to clamper part 616.Perhaps, entering member body 610 can integrally construct, and makes tubular portion 614 and clamper part 616 be oriented relative to one another to an integral body.Should be appreciated that entering member body 610 is not limited to columniform tubular portion 614 and clamper part 616, and enter member body 610 and can or be constructed to limit any other geometry as required.

Enter member 606 and can for example limit contact surface 618 at the near-end 610a place that enters member 606.Contact surface 618 for example can be configured to when awl 609 when entering member 606 and be fully inserted into contact surface 618 in abutting connection with the complementary contact surface that is limited by awl 609.Enter member can be configured to insert at least in part be limited to target anatomical position 24 places opening 25(referring to Figure 32 F).Opening 25 can be limited by awl 609, and is as described in greater detail below.The outer surface that enters the tubular portion 614 of member 606 can limit at least one sounding mark (for example a plurality of sounding marks), and described sounding mark is spaced apart with corresponding preset distance with respect to the far-end 610b that enters member 606.Sounding mark can be used for determining to enter the far-end 610b of member 606 with respect to the insertion depth of opening 25.

Awl 609 longitudinally L is elongated, and is included in the opening that extends between near-end 620a and the relative far-end 620b and forms member body 620.In accordance with the embodiments illustrated, awl main body 620 can comprise having relative near-end 622a and the shaft portion 622 of far-end 622b, and the clamper part 624 with relative near-end 624a and far-end 624b.Shaft portion 622 can limit the D outer diameter 2 of the diameter D1 that is slightly less than intubate 612, make when awl 609 when entering member 606 and carry, awl 609 longitudinally L with respect to entering member 606 translations.

Clamper part 624 can limit external diameter, and this external diameter is greater than the D outer diameter 2 of shaft portion 622, and can be substantially equal to enter the external diameter of the clamper part 616 of member 606.Should be appreciated that awl main body 620 is not limited to columniform tubular portion 622 and clamper part 624, and awl main body 620 can or be constructed to limit any other geometry as required.

The shaft portion 622 of awl 609 can have as being limited to the length between near-end 622a and the far-end 622b, this length is longer than as being limited to the length that enters member 606 between near-end 610a and the far-end 610b, make when awl 609 when entering member 606 and be fully inserted into, at least a portion of shaft portion 622 is given prominence to above entering the far-end 610b of member 606.The ledge of shaft portion 622 can be biased in the target anatomical position 24, in order to form opening 25 at target anatomical position 24 places, the size of this opening is configured to and anchor log 22 can be contained in wherein.

Awl 609 can limit contact surface 626, and this contact surface can be the mid portion with respect to near-end 620a and far-end 620b.For example, contact surface 626 can be limited at the far-end 624b place of the clamper part 624 of awl 609.Contact surface 626 for example can be configured to when awl 609 when entering member 606 and be fully inserted into, contact surface 626 is in abutting connection with the complementary contact surface that enters member 606, for example contact surface 618.Awl 609 also can be for example limits shock surface 628 at 620 near-end 620a place of main body, and this shock surface is configured to receive one or more impulsive forces, and is as described in greater detail below.

In accordance with the embodiments illustrated, awl 609 also can limit tip 630 at the far-end 620b place of main body 620, and this tip is configured to thrust in the tissue and/or bone at target anatomical position 24 places.Illustrated most advanced and sophisticated 630 can limit cone shape, and this cone shape is convergent distad at the far-end 620b place of main body 620.Conical tip 630 can be configured to be biased in the target anatomical position 24, thereby plays a role as awl or drift, and is to form opening 25 at target anatomical position 24 places, as described in greater detail below.The base portion part of conical tip 630 can limit the diameter that is slightly less than awl 609 D outer diameter 2, make the far-end 620b of main body 620 limit the flange 631 of the base portion of contiguous conical tip 630, this flange is configured to during the formation of opening 25 tissue and/or bone be dug core.During the formation of opening 25, tissue and/or the bone that is replaced by awl 609 dug core, can when opening 25 is withdrawn from, alleviate tissue at awl 609 and collapse.

According to alternative embodiment, opening forms member 608 can be configured to drill bit 611(referring to Figure 32 D).For example, the shaft portion 622 that opening forms member 608 can limit at least one (for example a plurality of) bore hole groove 632, this bore hole groove extends from most advanced and sophisticated 630 spirality ground along the direction towards contact surface 626, and bore hole groove 632 is configured to form opening 25 by the boring material from target anatomical position 24 when revolving force is applied to drill bit 611.

Insert in the first of program in exemplary anchor member, enter assembly 602 and be used in target anatomical position 24 places formation opening 25.For example, in the first step, the shaft portion 622 of awl 609 can insert in the intubate 612 that enters member 606 and distad advance in intubate 612, is adjacent to each other up to contact surface 618 and 626.The tip 630 of awl 609 can be arranged on the required tip place of piercing through at target anatomical position 24 places then.Apply at least one (for example a plurality of) impulsive force by the shock surface 628 to awl 609, awl 609 can be biased target approach anatomical position 24 then.When shaft portion 622 was advanced in the target anatomical position 24, opening 25 can be limited by tip 630 and the flange 631 of shaft portion 622.When entering assembly 602 and further be advanced in the target anatomical position 24, the far-end 614b that enters the shaft portion 614 of member 606 can insert (referring to Figure 32 E) in the opening 25 at least in part, for example up to the outer surface substantial alignment of one of above-mentioned sounding mark with target anatomical position 24.To enter member 606 inserts opening 25 at least in part and can make that to enter member 606 fixing with respect to opening 25.Be fixed in the opening 25 in case enter member 606, just awl 609 can be withdrawn from (referring to Figure 32 F) from entering member 606.Under the situation that awl 609 has removed, enter member 606 be configured to the miscellaneous part that inserts apparatus 600 provide lead to target anatomical position 24(and more specifically be opening 25) path.

For example, can use anchor log inserter assembly 604 in opening 25, to insert and/or expansion anchor log 22 then, as described in greater detail below.Illustrated anchor log inserter assembly 604 comprises and enters member 606, anchor log shell 634 and pusher member 636, this anchor log shell carries anchor log 22 releasedly and is configured to insert and enters in the member 606, and described pusher member 636 is configured to insert in the anchor log shell 634 and is configured to anchor log 22 from 634 ejections of anchor log shell.

Illustrated anchor log shell 634 longitudinally L is elongated, and is included in the anchor log housing main body 638 that extends between near-end 638a and the relative far-end 638b.Anchor log shell 634 is limited to the intubate 640 that vertical L upper edge central axis C extends through anchor log shell 634.The size of intubate 640 can be configured to carry anchor log 22 therein releasedly.For example, intubate 640 can have diameter D3, this diameter is enough narrow so that anchor log 22 is supported in the intubate 640, make anchor log 22 can from anchor log shell 634, not drop out, and diameter D3 again enough wide with allow anchor log for example in response to the power that is applied to anchor log 22 by pusher member 636 in intubate 640 longitudinally L by translation.

In accordance with the embodiments illustrated, anchor log 22 is arranged on the far-end 638b place of anchor log shell 634, simultaneously at least one or a plurality of actuation member 37(are for example, at least one activates strand 38, for example work as anchor log and (for example comprise many, greater than 2) when activating strand many activate strands 38) in intubate 640, freely extend, and extend the near-end 638a of anchor log shell 634.Should be appreciated that anchor log 22 can or be arranged on the diverse location place in the intubate 640 as required.The size of intubate 640 also can be configured to hold therein at least a portion of pusher member 636, makes anchor log shell 634 be configured to carry pusher member 636.For example, diameter D3 can be a bit larger tham the D outer diameter 4 of the complementary portion of pusher member 636, make pusher member 636 can be in intubate 640 longitudinal translation.

Anchor log housing main body 638 can be two parts main body, and described two parts main body comprises having relative near-end 642a and the tubular portion 642 of far-end 642b, and the clamper part 644 with relative near-end 644a and far-end 644b.Clamper part 644 can limit the external diameter greater than the external diameter of tubular portion 642.Tubular portion 642 can have the external diameter of the external diameter that is substantially equal to awl 609.In other words, tubular portion 642 can have D outer diameter 2, make when anchor log shell 634 when entering member 606 and carry, anchor log shell 634 can be with respect to entering member 606 L translation longitudinally.The near-end 642a of tubular portion 642 can cave among the far-end 644b of clamper part 644 at least in part.For example, clamper part 644 can be overmolded onto on the tubular portion 642.Perhaps, tubular portion 642 can be attached to clamper part 644.Perhaps, anchor log housing main body 638 can integrally be constructed, and makes tubular portion 642 and clamper part 644 be oriented relative to one another to an integral body.Should be appreciated that anchor log housing main body 638 is not limited to columniform tubular portion 642 and clamper part 644, and anchor log housing main body 638 can or be constructed to limit any other geometry as required.

In accordance with the embodiments illustrated, anchor log shell 634 can for example limit at least one (for example a pair of) contact surface in the relative end of clamper part 644, this contact surface is configured in abutting connection with entering the complementary contact surface of member 606 and pusher member 636.More specifically, anchor log shell 634 can limit first contact surface 646, and this first contact surface can be the mid portion with respect to near-end 638a and far-end 638b.For example, contact surface 646 can be limited at the far-end 644b place of clamper part 644.Contact surface 646 for example can be configured to when anchor log shell 634 when entering member 606 and be fully inserted into, contact surface 646 is in abutting connection with the complementary contact surface that enters member 606, for example contact surface 618.Anchor log shell 634 also can for example limit second contact surface 648 at the near-end 644a place of clamper part 644.Contact surface 648 for example can be configured to when pusher member 636 is fully inserted into respect to anchor log shell 634, and contact surface 648 is in abutting connection with the complementary contact surface of pusher member 636, and for example contact surface 658.

The shaft portion 642 of anchor log housing main body 638 can have as the length between the far-end 642b of the far-end 644b that is limited to clamper part 644 and shaft portion 642, this length is longer than the length that enters member 606, make when anchor log shell 634 when entering member 606 and be fully inserted into, the far-end 638b of anchor log shell 634 gives prominence to (referring to Figure 32 I) above entering the far-end 610b of member 606.When contact surface 646 during in abutting connection with contact surface 618, anchor log shell 634 is fully inserted into respect to entering member.

Illustrated pusher member 636 longitudinally L is elongated, and is included in the pusher member main body 650 of extending between near-end 650a and the relative far-end 650b.Pusher member 636 is limited to the intubate 652 that vertical L upper edge central axis C extends through pusher member 636.The size of intubate 652 can be configured to make pusher member 636 will make anchor log 22 eject and enter opening 25 from anchor log shell 634, as described in greater detail below, and make anchor log 22 carry the actuating strand 38 of anchor log 22 therein and eject from the near-end 638a of anchor log shell 634.

In accordance with the embodiments illustrated, pusher member main body 650 can be two parts main body, described two parts main body comprises having relative near-end 654a and the tubular portion 654 of far-end 654b, and the clamper part 656 with relative near-end 656a and far-end 656b.Tubular portion 654 can have the D outer diameter 4 of the diameter D3 of the intubate 640 that is slightly less than anchor log shell 634, make when pusher member 636 is carried by anchor log shell 634, pusher member 636 longitudinally L with respect to 634 translations of anchor log shell.Clamper part 656 can limit external diameter, and this external diameter is greater than the external diameter of tubular portion 654.The near-end 654a of tubular portion 654 can cave among the far-end 656b of clamper part 656 at least in part.For example, clamper part 656 can be overmolded onto on the tubular portion 654.Perhaps, tubular portion 654 can be attached to clamper part 656.Perhaps, pusher member main body 650 can integrally be constructed, and makes tubular portion 654 and clamper part 656 be oriented relative to one another to an integral body.Should be appreciated that pusher member main body 650 is not limited to columniform tubular portion 654 and clamper part 656, and pusher member main body 650 can or be constructed to limit any other geometry as required.

Pusher member 636 can limit contact surface 658, and this contact surface for example is configured to when pusher member 636 is fully inserted into respect to anchor log shell 634, and this contact surface is in abutting connection with the complementary contact surface of anchor log shell 634.Contact surface 658 can be the mid portion with respect to near-end 650a and far-end 650b.For example, contact surface 658 can be limited at the far-end 656b place of clamper part 656.Contact surface 658 for example can be configured to when pusher member 636 is fully inserted into respect to anchor log shell 634, and contact surface 658 is in abutting connection with the complementary contact surface of anchor log shell 634, and for example contact surface 648.

The shaft portion 654 of pusher member main body 650 can have as the length between the far-end 654b of the far-end 656b that is limited to clamper part 656 and shaft portion 654, this length is longer than the length of the clamper part 644 that enters member 606 and anchor log shell 634, make when anchor log shell 634 and pusher member 636 when entering member 606 and be fully inserted into, the far-end 650b of pusher member 636 gives prominence to (referring to Figure 32 K) from the far-end 610b that enters member 606 and the far-end 638b of anchor log shell 634.When contact surface 658 during in abutting connection with contact surface 648, pusher member 636 is fully inserted into respect to anchor log shell 634.

Insert in the second portion of program in exemplary anchor member mentioned above, fix with respect to opening 25 in case used to enter assembly 602 at target anatomical position 24 places formation opening 25 and will enter member 606, anchor log inserter assembly 604 just can be used to anchor log 22 is inserted in the openings 25.For example, the shaft portion 642 of anchor log shell 634 can insert in the intubate 612 that enters member 606 and distad advance in intubate 612, up to contact surface 618 and 646 be adjacent to each other (referring to Figure 32 I).Along with anchor log shell 634 is fully inserted into respect to entering member 606, can use pusher member 636 that anchor log 22 is ejected from the far-end 610b that enters member 606, spring into opening 25 then.For example, the tubular portion 654 of pusher member 636 can insert in the intubate 640 of anchor log shell 634, and distad advances in intubate 640.When the tubular portion 654 of pusher member 636 advances in intubate 640, the far-end 650b of pusher member 636 can contact with anchor log 22, and make anchor log 22 towards the far-end 606b translation that enters member 606, and eject (referring to Figure 32 K) from the far-end 610b that enters member 606.

When anchor log 22 when the far-end 610b that enters member 606 ejects and enter opening 25, tension force can be applied to and activate strand 38, thereby anchor log 22 is expanded in opening 25, and with respect to target anatomical position 24 become fixing (referring to Figure 32 L).Tension force is applied to activate strand 38 during, power can be applied to one or more parts of anchor log inserter assembly 604, described power along with the direction of tension force roughly the relative direction direction of head for target anatomical position 24 (for example along) apply.When anchor log 22 has expanded in opening 25 and fixedly the time, the parts of anchor log inserter assembly 604 can be removed from target anatomical position 24.

Referring now to Figure 32 M,, the anchor log shell can or be provided as sleeve pipe 660, described sleeve pipe is configured to carry anchor log 22, be configured to be arranged on the end of pusher member 636 so that pusher member 636 carrying sleeve pipes 660, and is configured to insert and enters in the member 606.Sleeve pipe 660 can be included in the cylindrical shroud tube body 664 that extends between near-end 664a and the relative far-end 664b.The size of casing main body 664 can be configured to be accommodated among the second bore hole 616d that enters member 606.Casing main body 664 can limit the intubate 662 that is configured to carry releasedly anchor log 22.For example, in accordance with the embodiments illustrated, sleeve pipe 660 is configured to carry anchor log 22, makes that the far-end 650b of pusher member 636 is in abutting connection with the near-end of anchor log 22 when sleeve pipe is carried by pusher member 636.The size of sleeve pipe 660 also can be configured to make when anchor log 22 is arranged in the sleeve pipe 660, and with respect to entering before member 606 is fully inserted into, anchor log 22 will resist the translation in intubate 662 at sleeve pipe.Casing main body 664 also can be for example limits contact surface 666 at near-end 664a place, described contact surface be configured to when sleeve pipe 660 when entering member 606 and be fully inserted in abutting connection with contact surface 618.The contact surface 666 of diagram sleeve pipe 660 is limited by flange 668, and flange 668 is limited by the near-end 664a of casing main body 664.

In operation, sleeve pipe 660 can be inserted in the intubate 612 that enters member 606, and distad advances in intubate 612, is adjacent to each other up to contact surface 666 and 618.Alternatively, sleeve pipe 660 can be inserted in the intubate 612 that enters member 606, and distad advances in intubate 612, up to the far-end 616e of the far-end 664b of the sleeve pipe adjacency second bore hole 616d.In accordance with the embodiments illustrated, with respect to entering before member 606 is fully inserted into, anchor log 22 is with not translation in intubate 662 at sleeve pipe 660.In case sleeve pipe 660 is fully inserted into respect to entering member 606, further apply the far-end 650b that power just will make pusher member 636 to pusher member 636, thereby make anchor log 22 translate across the intubate 662 of sleeve pipe 660 and pass intubate 612, eject from the far-end 610b that enters member 606 subsequently.In case anchor log 22 ejects and enters the opening 25 from the far-end 610b that enters member 606, anchor log is just inflatable, and the parts of anchor log inserter assembly 604 just can be removed as mentioned above.

Referring now to Figure 33 A-C,, shows the alternative embodiment that inserts apparatus 600 '.Insert apparatus 600 ' and can comprise and enter assembly 602, be used for for example forming opening 25.Insert apparatus 600 ' and also can comprise anchor log inserter assembly 604 ', this anchor log inserter assembly can comprise the parts of anchor log inserter assembly 604, for example enters member 606 and anchor log shell 638 and/or sleeve pipe 660.Anchor log inserter assembly 604 ' also can comprise the tension force assembly, and for example the tension force assembly 700, and this tension force assembly 700 is configured to predetermined tension characteristic is applied to the actuating strand 38 of anchor log 22.

In accordance with the embodiments illustrated, tension force assembly 700 comprises pusher member 702, this pusher member i.e. a motion assembly, this motion assembly can comprise first member of advancing, for example be configured to the advance translation member 704 of (for example translation preset distance) with respect to the far-end 610b that enters member 606, this motion assembly also can comprise second member of advancing, for example rotating parts 706, this rotating parts operationally is attached to pusher member 702 and translation member 704, make the rotation of rotating parts 706 make translation member 704 with respect to enter member 606 far-end 610b, and with respect to pusher member 702 translation preset distances.Should be appreciated that from following description that tension force assembly 700 makes equally and activate the strand 38 predetermined distance of advancing substantially.In this, should be appreciated that tension characteristic can be preset distance.

Pusher member 702 can adopt basically the mode identical with pusher member 636 to construct, pusher member 702 also comprises at least one (for example a pair of) coupling member 708, this coupling member is configured to cooperate with the complementary coupling member 710 that is limited by rotating parts 706, thereby pusher member 702 operationally is attached to rotating parts 706, makes that rotating parts 706 can be with respect to pusher member 702 rotations.In accordance with the embodiments illustrated, the form that pusher member 702 can a pair of protuberance 712 limits a pair of coupling member 708, and the opposite side of protuberance 712 along the rotation axis R that shares from pusher member 702 extends, and described shared rotation axis R extends along side direction A.Protuberance 712 can be configured to for example cooperate in hole 714 with the complementary coupling member 710 that is limited by rotating parts 706.Rotating parts 706 can be configured to the rotation around rotation axis R, makes that pusher member 702 can keep static with respect to rotating parts 706 when rotating parts 702 rotations.

Translation member 704 can comprise at least one (for example a pair of) coupling member 708, and this coupling member is configured to cooperate with the complementary coupling member 710 that is limited by rotating parts 706, thereby translation member 704 operationally is attached to rotating parts 706.Translation member 704 can be configured to respect to pusher member 702 distad translation between middle position and extended position, for example L longitudinally.For example, translation member 704 can be configured to translation between middle position and extended position when rotating parts 706 rotates around rotation axis R, thereby with respect to the far-end 610b translation that enters member 606.

The actuating strand 38 of anchor log 22 can be for example presss from both sides to translation member 704 and is attached to translation member 704 releasedly by activating strand 38, make when translation member 704 when entering the far-end 610b proximad translation of member 606, translation member 704 can be applied to tension force the actuating strand 38 of anchor log 22, thereby anchor log 22 is expanded in opening 25.Therefore, should be appreciated that translation member 704 can limit the assembly that grasps that is configured to be attached to releasedly actuating strand 38, in order to when translation member is advanced preset distance, the stretching actuation force is applied to the actuating strand.The degree that anchor log 22 expands can be depending on the size that translation member 704 is applied to the tension force that activates strand 38.The size of described tension force can be depending on middle position that 704 translations of translation member pass through and the distance between the extended position.Therefore, the translation member 704 big I that will be applied to the tension force that activates strand 38 is determined by middle position and the preset distance between the extended position of translation member 704 at least in part.

Distance between middle position and the extended position can determine that described coupling member 708 is limited by translation member 704 by coupling member 708 and complementary coupling member 710, and the coupling member 710 of described complementation is limited by rotating parts 706.For example, in accordance with the embodiments illustrated, the form that translation member 704 can a pair of protuberance 716 limits a pair of coupling member 708, and protuberance 716 extends along common axis from the opposite side of translation member 704, and described common axis is extended along side direction A.Protuberance 716 can be configured to cooperate with the coupling member 710 of complementation, the coupling member 710 of described complementation by rotating parts 706 for example slit 718 limit, each slit 718 extends between the terminal 718a of relative nearside slit and distally slit end 718b respectively.When protuberance 716 was arranged on the terminal 718a of nearside slit place, translation member 704 can be in the middle position, and when protuberance 716 was arranged on the terminal 718b of distally slit place, translation member 704 can be in extended position.Rotating parts 706 can make protuberance 716 translation between the terminal 718a of nearside slit and the terminal 718b of distally slit in slit 718 around the rotation of rotation axis R, thereby makes translation member 704 translation between middle position and extended position.

Rotating parts 706 can comprise at least one (for example a pair of) coupling member 710, this coupling member is configured to cooperate with the complementary coupling member 708 that is limited by pusher member 702 and/or translation member 704, thereby rotating parts 706 operationally is attached to pusher member 702 and/or translation member 704.In accordance with the embodiments illustrated, rotating parts 706 comprises pair of plate-shaped main component 720, and described plate-like body member 720 is arranged on the opposite side of pusher member 702 and translation member 704.Each plate-like body member 720 limits first coupling member 710 with the form that is defined the hole 714 of passing plate-like body member 720, and limit second coupling member 710 with the form that is defined the elongated slot 718 of passing plate-like body member 720, hole 714 is configured to hold the corresponding protuberance 712 of pusher member 702, elongated slot 718 is extended between the terminal 718a of nearside slit and the terminal 718b of distally slit, and slit 718 is configured to hold the corresponding protuberance 716 of translation member 704.Illustrated slit 718 is linear between the terminal 718a of nearside slit and the terminal 718b of distally slit, but slit can or limit other geometries.For example, slit 718 can be crooked.Plate-like body member 720 can for example be coupled to each other by a pair of bridging element 722.In accordance with the embodiments illustrated, can translation member 704 be moved to extended position from the middle position by rotating parts being rotated substantially 90 degree.Be to be understood that, tension force assembly 700 is not limited to the diagram geometry of its various parts, and one or more parts of tension force assembly 700 can or use any other suitable geometry to construct as required, for example have the main component 720 of different geometries.

Fix with respect to target anatomical position 24 according to using the exemplary anchor member of inserting apparatus 600 ' to insert program, can use to enter assembly 602 at target anatomical position 24 places formation opening 25 and/or will enter member.Be fixed in case enter member 606, just can use anchor log inserter assembly 604 ' that anchor log 22 is inserted in the opening 25.For example, the shaft portion 642 of anchor log shell 634 can insert in the intubate 612 that enters member 606 and distad advance in intubate 612, is adjacent to each other up to contact surface 618 and 646.Along with anchor log shell 634 is fully inserted into respect to entering member 606, can use tension force assembly 700 that anchor log 22 is ejected from the far-end 610b that enters member 606, spring into opening 25 then.For example, the tubular portion 654 of pusher member 702 can be inserted in the intubate 640 of anchor log shell 634, and distad advances in intubate 640.When the tubular portion 654 of pusher member 702 advanced in intubate 640, the far-end 650b of pusher member 702 can contact with anchor log 22, and anchor log 22 is ejected towards the far-end 610b translation that enters member 606 and from the far-end 610b that enters member 606.

When anchor log 22 when the far-end 610b that enters member 606 ejects and enter opening 25, can use tension force assembly 700 that tension force is applied to and activate strand 38, thereby anchor log 22 is expanded in opening 25, and become fixing with respect to target anatomical position 24.Can be by revolving force being applied to rotating parts 706 tension force be applied to and activates strand 38, thereby make protuberance 716 move to the terminal 716b of distally slit from the terminal 716a of nearside slit, and make translation member 704 move to extended position from the middle position.When translation member 704 moved to extended position from the middle position, translation member 704 can be applied to tension force and activate strand 38, thereby anchor log 22 is expanded in opening 25, and becomes fixing with respect to target anatomical position 24.

During the rotation of rotating parts 706, power can be applied to one or more parts of anchor log inserter assembly 604 ', described power along with the direction that is applied to the tension force that activates strand 38 roughly the relative direction direction of head for target anatomical position 24 (for example along) apply.When anchor log 22 has expanded in opening 25 and fixedly the time, the parts of anchor log inserter assembly 604 ' can be removed from target anatomical position 24.

Referring now to Figure 34 A-C,, show and insert apparatus 600 ' ' another alternative embodiment.Insert apparatus 600 ' ' can comprise the awl 609 that enters assembly 602, be used for (for example) and form opening 25.Insert apparatus 600 ' ' also can comprise anchor log inserter assembly 604 ' ', described anchor log inserter assembly 604 ' ' can comprise various parts, for example enter member 606 ' ', anchor log shell 638 ' ' and/or the sleeve pipe 660 of anchor log inserter assembly 604.Anchor log inserter assembly 604 ' ' also can comprise the tension force assembly, for example the tension force assembly 800, and described tension force assembly 800 is configured to tension force is applied to the actuating strand 38 of anchor log 22.

Enter member 606 ' ' can be constructed to enter member 606 substantially the same, enter member 606 ' simultaneously ' also limit at least one interlocking component 670, described interlocking component 670 be configured to by anchor log shell 634 ' ' the complementary interlocking component 670 that limits engages, make when interlocking component 670 is engaged with each other, prevent from entering member 606 ' ' and anchor log shell 634 ' ' relative to each other rotate around central axis C.In accordance with the embodiments illustrated, enter member 606 ' ' limit a pair of interlocking component 670 with the form of a pair of recess 672, recess 672 is entering member 606 ' along horizontal T ' outer surface and its tubular portion 614 between extend into ' near-end 610a, described recess 672 is configured to hold by anchor log shell 634 ' ' the complementary interlocking component 670 that limits that enters member 606 '.Enter member 606 ' ' also can limit at least one supporting member 674, this supporting member 674 be configured to allow reverse rotation power is applied to enter member 606 ' ', as described in greater detail below.The opposite side of ' clamper part 616 limit pair of supporting members 674 with the form of contact pin 676, contact pin 676 is from entering member 606 ' ' extends along common axis in accordance with the embodiments illustrated, to enter member 606 ', and described common axis is extended along side direction A.

Anchor log shell 634 ' ' can be constructed to substantially the same with anchor log shell 634, simultaneously the anchor log shell 634 ' ' also limit at least one (for example a plurality of) interlocking component 670, this interlocking component 670 be configured to by entering member 606 ' ' and the respective complementary interlocking component 670 that limits of the pusher member 802 of tension force assembly 800 engage, making and prevent from entering member 606 ' when corresponding interlocking component 670 is engaged with each other ', anchor log shell 634 ' ' and pusher member 802 to center on central axis C relative to each other rotates.In accordance with the embodiments illustrated, anchor log shell 634 ' ' limit a plurality of interlocking components 670 with the form of a butt strip 678 and a pair of recess 672, this butt strip 678 along horizontal T at anchor log shell 634 ' ' outer surface and its tubular portion 642 between from anchor log shell 634 ' ' the far-end 644b of clamper part 644 extend, described contact pin 678 is configured to be contained in by entering member 606 ' ' in the corresponding person of the recess 672 that limits, and this to recess 672 along horizontal T at anchor log shell 634 ' ' outer surface and its tubular portion 642 between extend into anchor log shell 634 ' ' the near-end 644a of clamper part 644, described recess 672 is configured to hold the complementary interlocking component 670 that is limited by pusher member 802.

In accordance with the embodiments illustrated, tension force assembly 800 comprises pusher member 802, translation member 804 and rotating parts 806, described translation member 804 is configured to respect to entering member 606 ' ' far-end 610b translation, described rotating parts 806 operationally is attached to pusher member 802 and translation member 804, makes the rotation of rotating parts 806 make translation member 804 with respect to enter member 606 far-end 610b and with respect to pusher member 802 translations.

Pusher member 802 can be constructed to pusher member 702 roughly the same, simultaneously pusher member 802 also comprises at least one ways 808, and described at least one ways 808 is configured to rotate with respect to rotating parts 806 when translation member 804 prevents translation member 804 during translation between middle position and extended position.In accordance with the embodiments illustrated, pusher member 802 limits the ways 808 of pair of tracks 810 forms, and track 810 longitudinally L extends between the near-end 806a of the near-end 802a of pusher member 802 and rotating parts 806.Illustrated track 810 longitudinally T is spaced apart from each other.

Pusher member 802 also can limit at least one (for example a plurality of) interlocking component 670, this interlocking component 670 be configured to by anchor log shell 634 ' ' the complementary interlocking component 670 that limits engages.In accordance with the embodiments illustrated, pusher member 802 can a butt strip 678 form limit interlocking component 670, contact pin 678 extends out along the horizontal T far-end 802b from pusher member 802 between the outer surface of pusher member 802 and its tubular portion 654, and described contact pin 678 is configured to be contained in by anchor log shell 634 ' ' in the corresponding person of the recess 672 that limits.

Pusher member 802 still also can limit at least one (for example a pair of) coupling member 812, this coupling member 812 is configured to cooperate with the complementary coupling member 814 that is limited by rotating parts 806, thereby pusher member 802 operationally is attached to rotating parts 806, makes that rotating parts 806 can be with respect to pusher member 802 rotations.In accordance with the embodiments illustrated, the form that pusher member 802 can a pair of protuberance 816 limits a pair of coupling member 812, and protuberance 816 extends along common axis from the opposite side of pusher member 702, and described common axis is extended along side direction A.Protuberance 816 can be configured to the ring-shaped groove 828 for example with at least one the complementary coupling member 814(that is limited by rotating parts 806) cooperate.Rotating parts 806 can be configured to and can make that pusher member 802 can keep static with respect to rotating parts 806 when rotating parts 806 rotations around the central axis C rotation.

Translation member 804 can be constructed to translation member 704 roughly the same, translation member 804 comprises that also a pair of longitudinal extension passes the hole 818 of translation member 804 simultaneously, each hole 818 is configured to corresponding in the holding track 810, makes translation member 804 take along track 810 when translation.Translation member 804 also can comprise at least one (for example a pair of) coupling member 812, this coupling member 812 is configured to cooperate with the complementary coupling member 814 that is limited by rotating parts 806, thereby translation member 804 operationally is attached to rotating parts 806.Translation member 804 can be configured to respect to pusher member 802 distad translation between middle position and extended position, for example L longitudinally.For example, translation member 804 can be configured to when rotating parts 806 translation between middle position and extended position during around the central axis C rotation, thus with respect to entering member 606 ' ' far-end 610b translation.

The actuating strand 38 of anchor log 22 can be for example presss from both sides to translation member 804 and is attached to translation member 804 releasedly by activating strand 38, make when translation member 804 with respect to entering member 606 ' ' the translation of far-end 610b proximad the time, translation member 804 can be applied to tension force the actuating strand 38 of anchor log 22, thereby anchor log 22 is expanded in opening 25.The degree that anchor log 22 expands can be depending on the size that translation member 804 is applied to the tension force that activates strand 38.The size of described tension force can be depending on middle position that 804 translations of translation member pass through and the distance between the extended position.Therefore, the translation member 804 big I that will be applied to the tension force that activates strand 38 is determined by middle position and the preset distance between the extended position of translation member 804 at least in part.

Distance between middle position and the extended position can determine that described coupling member 812 is limited by translation member 804 by coupling member 812 and complementary coupling member 814, and the coupling member 814 of described complementation is limited by rotating parts 806.For example, in accordance with the embodiments illustrated, translation member 804 can limit a pair of coupling member 812 with the form of a pair of protuberance 820, and protuberance 820 extends along common axis from the opposite side of translation member 804, and described common axis is extended along side direction A.Protuberance 820 can be configured to by rotating parts 806 for example the complementary coupling member 814 that limits of helicla flute 830 cooperate, each helicla flute 830 extends between the terminal 830a of relative nearside groove and distally groove end 830b respectively.When protuberance 820 was arranged on the terminal 830a of nearside groove place, translation member 804 can be in the middle position, and when protuberance 820 was arranged on the terminal 830b of distally groove place, translation member 804 can be in extended position.Rotating parts 806 can make protuberance 820 translation between the terminal 830a of nearside groove and the terminal 830b of distally groove in helicla flute 830 around the rotation of central axis C, thereby makes translation member 804 translation between middle position and extended position.

Rotating parts 806 can comprise at least one (for example a pair of) coupling member 814, this coupling member 814 is configured to cooperate with the complementary coupling member 812 that is limited by pusher member 802 and/or translation member 804, thereby rotating parts 806 operationally is attached to pusher member 802 and/or translation member 804.In accordance with the embodiments illustrated, rotating parts 806 comprises cylinder-shaped body 822, and described main part limitation extends through the intubate 824 of main body along central axis C.The size of intubate 824 can be configured to and pusher member 802 and translation member 804 can be contained in wherein.Intubate limits inner surface 826.Main body 822 limits a plurality of coupling members 814 with the form of ring-shaped groove 828 and a pair of relative helicla flute 830, and described ring-shaped groove 828 and helicla flute 830 extend in the inner surface 826.Protuberance 816 can be trapped in the ring-shaped groove 828, makes when rotating parts 806 rotations, prevents that pusher member 802 is with respect to rotating parts 806 translations.Each be trapped in helicla flute 830 in the protuberance 820 corresponding one in, make when rotating parts 806 rotations, protuberance 820 translation in helicla flute 830 accordingly, thereby make translation member 804 move to extended position from the middle position.

Helicla flute 830 extends between the terminal 830a of relative nearside groove and the terminal 830b of distally groove.In accordance with the embodiments illustrated, helicla flute 830 can limit corresponding variable groove slot pitch.The groove slot pitch can reduce between the terminal 830a of corresponding nearside groove and the terminal 830b of distally groove, make that the size that translation member 804 is applied to the tension force that activates strand 38 increases with the distance of translation member 804 with pusher member 802 for each unit of the swing offset of rotating parts 806.Should be appreciated that tension force assembly 800 is not limited to the illustrated geometry of its various parts, and one or more parts of tension force assembly 800 can or use as required any other suitable geometry to construct.

According to utilize inserting apparatus 600 ' ' exemplary anchor member insert program, enter member 606 ' ' can use with awl 609, in order to form opening 25 at target anatomical position 24 places and/or will enter member 606 ' ' fixing with respect to target anatomical position 24.In case enter member 606 ' ' be fixed, just can use anchor log inserter assembly 604 ' ' anchor log 22 is inserted in the opening 25.In the intubate 612 of for example, anchor log shell 634 ' ' shaft portion 642 can insert enter member 606 ' ' and in intubate 612, distad advance, be adjacent to each other up to contact surface 618 and 646.' with respect to entering member 606 ' ' is fully inserted into along with anchor log shell 634 ', can use tension force assembly 800 with anchor log 22 from entering member 606 ' ' far-end 610b eject, spring into opening 25 then.For example, the tubular portion 654 of pusher member 802 can insert in the intubate 640 of anchor log shell 634, and distad advances in intubate 640.When the tubular portion 654 of pusher member 802 advances in intubate 640, the far-end 610b that the far-end 650b of pusher member 802 can contact with anchor log 22, and makes anchor log 22 towards entering member 606 ' ' far-end 610b translation and from entering member 606 ' ' ejects.

When anchor log 22 from entering member 606 ' ' far-end 610b eject and when entering opening 25, can use tension force assembly 800 that tension force is applied to and activate strand 38, thereby anchor log 22 is expanded in opening 25, and become fixing with respect to target anatomical position 24.Can be by revolving force being applied to rotating parts 806 tension force be applied to and activates strand 38, thereby protuberance 830 is held level with both hands from the terminal 830a of nearside groove accordingly moves to the terminal 830b of distally groove, and make translation member 804 from the middle position to extended position translation preset distance.When translation member 804 moved to extended position from the middle position, translation member 804 can be applied to tension force and activate strand 38, thereby anchor log 22 is expanded in opening 25, and became fixing with respect to target anatomical position 24.

During the rotation of rotating parts 806, can along with the direction of the revolving force that is applied to rotating parts 806 roughly relative direction revolving force is applied in the contact pin 676 at least one, to prevent anchor log inserter assembly 604 ' ' parts with respect to 24 rotations of target anatomical position.When anchor log 22 has expanded in opening 25 and fixedly the time, can be with anchor log inserter assembly 604 ' ' parts remove from target anatomical position 24.

Referring now to Figure 35,, show and insert apparatus 600 ' ' ' another alternative embodiment.Insert apparatus 600 ' ' ' can comprise enter assembly 602 ' ' ' and anchor log inserter assembly 604 ' ' '.Enter assembly 602 ' ' ' can comprise awl 609 ' ' ' and enter member 606 ' ' '.Anchor log inserter assembly 604 ' ' ' can comprise multiple parts, for example, enter member 606 ' ' ', anchor log shell 638 ' ' ' and/or the sleeve pipe 660 of anchor log inserter assembly 604.Anchor log inserter assembly 604 ' ' ' also can comprise the tension force assembly, for example, and tension force assembly 900, this tension force assembly 900 is configured to tension force is applied to the actuating strand 38 of anchor log 22.Tension force assembly 900 can comprise being configured to anchor log 22 ejected enter member 606 ' ' ' far-end 610b pusher member 902, be configured to the translation member 904 of translation between middle position and extended position, and the handle member 906 that operationally is attached to pusher member 902 and translation member 904, make translation to handle member 906 that pusher member is ejected anchor log 22 and enter member 606 ' ' ' far-end 610b, and make translation member 904 move to extended position from the middle position to the rotation of handle member 906.

Referring now to Figure 36 A-B,, ' ' can be configured to and enter member 606 ' ' is substantially the same to enter member 606 ', interlocking component 670 can be configured to prevent from entering member 606 ' simultaneously ' ' with respect to awl 609 ' ' ' or anchor log shell 634 ' ' ' rotation, and prevent from entering member 606 ' ' ' with respect to awl 609 ' ' ' or anchor log shell 634 ' ' ' translation.For example, in accordance with the embodiments illustrated, interlocking component 670 can square plate main body 680 form provide, this square plate main body is arranged on and enters member 606 ' ' ' near-end 610a place, and square plate main body 680 defines nearside or upper surface 680a, relative distally or lower surface 680b and four side surface 680c.Plate main body 680 can be configured to by awl 609 ' ' ' and/or anchor log shell 634 ' ' ' the complementary interlocking component 670 that limits keeps releasedly.For example, the plate main body can limit hypotenuse 680d, and the upper surface 680a of plate main body 680 and its side surface 680c intersect herein.Enter member 606 ' ' also can be limited to the lower surface 680b of plate main body 680 and enter member 606 ' ' ' near-end 610a between the cervical region 682 that extends, make groove 684 be limited at the lower surface 680b of plate main body 680 and enter member 606 ' ' ' near-end 610a between.Should be appreciated that and enter member 606 ' ' ' interlocking component 670 shown in being not limited to, and enter member 606 ' ' ' can or comprise the interlocking component that any other is suitable as required.

Awl 609 ' ' ' can be configured to identical with awl 609 basically, awl 609 ' ' ' also define at least one interlocking component 670, this interlocking component 670 be configured to by entering member 606 ' ' ' the complementary interlocking component 670 that limits engages releasedly.For example, according to shown in embodiment, awl 609 ' ' ' near-end 620a can limit the interlocking component 670 of a pair of relative latch member 686 forms, latch member 686 is configured to holding plate main body 680 releasedly.Each latch member 686 can be included in the flexible latch arms 688 of extending between near-end 688a and the relative far-end 688b.

Each latch arms 688 can comprise pivot member 690, and latch arms 688 can center on this pivot member (for example, around the pivot axis that is arranged essentially parallel to horizontal T) and pivot.The far-end 688b of each latch arms 688 can limit protuberance 692, this protuberance 692 limits distally or the lower surface 690b of nearside or upper surface 692a and inclination, when latch member 682 was latched on the plate main body 680, upper surface 692a was configured to the lower surface 680b of adjacent plate main body 680.

In operation, when awl 609 ' ' ' be inserted into enter member 606 ' ' ' in make awl 609 ' ' ' corresponding interlocking component and enter member 606 ' ' ' when engaging, but the corresponding hypotenuse 680d of the lower surface 692b adjacent plate main body 680 of each latch member 686, and can take along hypotenuse 680d, thereby the far-end 688b of latch arms 688 is outwards pivoted around corresponding pivot member 690 with respect to plate main body 680.When further propelling awl 609 ' ' time, protuberance 692 is taken along the corresponding side surface 680c of board member 680, lower surface 680b up to the upper surface 692a of protuberance process plate main body 680, at this moment, this protuberance enters groove 684 and latch arms 688 flexiblely is pivoted back to its home position, make latch arms 688 with the upper surface 692a stop motion of the protuberance 692 of the lower surface 680b of adjacent plate main body 680, thus holding plate main body 680.When awl 609 ' ' ' with respect to entering member 606 ' ' ' when breech lock is lived, prevented awl 609 ' ' ' with respect to entering member 606 ' ' ' L translation longitudinally, and prevented that it is with respect to entering member 606 ' ' ' around the central axis C rotation.Should be appreciated that awl 609 ' ' ' interlocking component 670 shown in being not limited to, and awl 609 ' ' ' can or limit any other suitable interlocking component as required.

Referring now to Figure 35 and Figure 37 A-B,, anchor log shell 634 ' ' ' can be configured to basically with anchor log shell 634 ' ' is identical, simultaneously as above in conjunction with awl 609 ' ' ' described, interlocking component 670 is limited to the far-end 644b place of clamper part 644, this gripper portion branch comprises a pair of latch member 686 that is configured to engages plate body 308, make when anchor log shell 634 ' ' ' with respect to entering member 606 ' ' ' when locking, prevented anchor log shell 634 ' ' ' with respect to entering member 606 ' ' ' L translation longitudinally, and prevented that it is with respect to entering member 606 ' ' ' around the central axis C rotation.Anchor log shell 634 ' ' ' also can limit second interlocking component 670 and the 3rd interlocking component 670, this second interlocking component is configured to engage the complementary interlocking component 670 that is limited by tension force assembly 900, to prevent that tension force assembly 900 is with respect to anchor log shell 634 ' ' ' rotation, and the 3rd interlocking component 670 is configured to engage the complementary interlocking component 670 that is limited by tension force assembly 900, to prevent that the tension force assembly is with respect to anchor log shell 634 ' ' ' L translation longitudinally, as describing in more detail hereinafter.

Anchor log shell 634 ' ' ' also can limit at least one ways, when translation member 904 between middle position and extended position during translation, this at least one ways is configured to prevent that translation member 904 is with respect to handle member 906 rotations.In accordance with the embodiments illustrated, anchor log shell 634 ' ' ' can limit the ways of pair of tracks 694 forms, track 694 extends in the proximal direction that is arranged essentially parallel to vertical L.Shown in track 694 can be spaced apart from each other along side direction A.

In accordance with the embodiments illustrated, tension force assembly 900 comprise being configured to anchor log 22 ejected enter member 606 ' ' ' the pusher member 902 of far-end 610b, be configured to respect to entering member 606 ' ' ' far-end 610b translation between middle position and extended position translation member 904 and operationally be attached to pusher member 902 and the handle member 906 of translation member 904, make translation to handle member 906 that pusher member is ejected anchor log 22 and enter member 606 ' ' ' far-end 610b, and the rotation to handle member 906 makes translation member 904 with respect to entering member 606 ' ' ' far-end 610b translation, thereby tension force is applied to the actuating strand 38 of anchor log 22.

Pusher member 902 can be included in the tubulose pusher member main body 908 of extending between near-end 908a and the relative far-end 908b.Can set the size of pusher member main body 908 as mentioned above, make that the far-end 908b of pusher member main body 908 can be at anchor log shell 634 ' the far-end 610b of ' ' in contact anchor log 22, and make anchor log 22 be entered member 606 ' by ejecting ' '.Pusher member 902 can be attached to translation member 904, is attached to its distal body portion 910b particularly.

Translation member 904 can limit at least one coupling member 914(such as a pair of coupling member 914), the complementary coupling member 916 that this coupling member is configured to limit with handle member 906 cooperates, thereby translation member 904 operationally is attached to rotating parts 906, make when handle member 906 during around the central axis C rotation, translation member 904 generals for example longitudinally L between middle position and extended position with respect to entering member 606 ' ' ' the translation of far-end 610b proximad.

In accordance with the embodiments illustrated, translation member 904 can limit a pair of coupling member 914 of a pair of protuberance 918 forms, and the opposite side of protuberance 918 along the common axis of extending at side direction A from translation member 904 extends.Protuberance 918 can be configured to for example relative helicla flute 920 of the complementary coupling member 916(that limits with handle member 906) cooperate, each helicla flute 920 extends between the terminal 920a of relative nearside groove and the terminal 920b of distally groove respectively.When protuberance 918 was arranged on the terminal 920b of distally groove place, translation member 904 can be in the middle position, and when protuberance 918 was arranged on the terminal 920a of nearside groove place, translation member 904 can be in extended position.

Referring now to Figure 37 B-39,, in accordance with the embodiments illustrated, handle member 906 comprises shank main body 922, and this shank main body 922 limits the central bore 924 of passing along central axis C from shank main body 922.The size of bore hole 924 can be configured to translation member 904 is contained in wherein.Bore hole 924 limits inner surface 926.Main body 922 limits a plurality of coupling members 916 of a pair of relative helicla flute 920 forms, and helicla flute 920 extends in the inner surface 926.Each be trapped in helicla flute 920 in the protuberance 918 corresponding one in, make when rotating parts 906 rotations, protuberance 918 translation in helicla flute 920 accordingly, thereby make translation member 904 move to extended position from the middle position.

Helicla flute 920 extends between the terminal 920a of relative nearside groove and the terminal 920b of distally groove.In accordance with the embodiments illustrated, helicla flute 920 can limit corresponding variable groove slot pitch.The groove slot pitch can reduce between the terminal 920a of corresponding nearside groove and the terminal 920b of distally groove, make that the size that is applied to the tension force that activates strand 38 by translation member 904 increases with the distance of translation member 904 with pusher member 902 for each unit of the swing offset of handle member 906.

In accordance with the embodiments illustrated, translation member 904 can be configured to serve as fusion components.For example, translation member 904 can be configured to lose efficacy when the tensile stress of specific size is applied to translation member 904, activates strand 38 thereby discharge.Be constructed in the exemplary embodiment of fusion components in translation member, translation member 904 can have two parts translation member main body 910, and this main body 910 comprises proximal body portion 910a and distal body portion 910b.Proximal body portion 910a and distal body portion 910b can be coupled to each other releasedly, make that proximal body portion 910a and distal body portion 910b will be as main body 910 translations together, tension force up to pre-sizing is applied to translation member main body 910, at this moment, distal body portion 910b can separate with proximal body portion 910a.In this regard, should be appreciated that predetermined tension characteristic can comprise the pre-sizing of tension force.Being applied at least one pre-sizing that activates the tension force of strand 38 can be limited by the travel distance of translation member 904 between middle position and extended position at least in part.Translation member main body 910, in other words proximal body portion 910a and distal body portion 910b can limit a pair of L longitudinally and extend through wherein hole 912, this hole 912 is configured to track 694 is contained in wherein, makes that translation member main body 910 can be in the vertical along track 694 translations.

The actuating strand 38 of anchor log 22 can be for example be clipped between proximal body portion 910a and the distal body portion 910b and be attached to translation member 904 releasedly by activating strand 38, make when translation member 904 with respect to entering member 606 ' ' the translation of far-end 610b proximad the time, translation member 904 can be applied to tension force the actuating strand 38 of anchor log 22, thereby anchor log 22 is expanded in opening 25.For example, in accordance with the embodiments illustrated, activate strand 38 and can be captured in respectively between apparent surface 911a, the 911b of proximal body portion 910a and distal body portion 910b.The degree that anchor log 22 expands can be depending on the size that is applied to the tension force that activates strand 38 by translation member 904.The big I that is applied to the tension force that activates strand 38 is with translation member 904 and enter member 606 ' ' far-end 610b between apart from increasing.

Also in accordance with the embodiments illustrated, proximal body portion 910a can limit protuberance 918, and the near-end 902a of pusher member 902 can be attached to distal body portion 910b.Proximal body portion 910a and distal body portion 910b can utilize at least one failure member to be coupled to each other releasedly.For example, in illustrated embodiment, proximal body portion 910a defines a pair of relative elastic fin 928 that distad extends from proximal body portion 910a, and each fin 928 defines the failure member of shearing contact pin 930 forms.Distal body portion 910b can limit the opposing flanges 932 of a pair of complementation, each flange 932 is configured to when proximal body portion 910a and distal body portion 910b are equipped with the actuating strand 38 that is clipped in therebetween, shears contact pin 930 with corresponding one and is contained in wherein.

The size of the bore hole 924 of handle member 906 can be set for and make that when translation member is carried in the bore hole 924 elastic fin 928 leans on distal body portion 910 and keeps fixing, and makes fin 928 outwards not setover.Therefore, when translation member 904 was made that by translation tension force is applied to translation member 904, shearing contact pin 930 can be against flange 932 biasing.Shear the release stress that shearing that contact pin 930 can be configured to resist flange equals to be scheduled to up to the size of tension force, for example enter member 606 ' when translation member 904 moves to distance ' far-end 610b certain distance and make when the size of tension force reaches predetermined release stress intensity, shearing contact pin 930 can be cut off by flange 932, to allow proximal body portion 910a to separate with distal body portion 910b, discharge from translation member 904 thereby will activate strand 38.Preferably, before translation member 904 moved to extended position, the big young pathbreaker who is applied to the tension force that activates strand 38 by translation member 904 surpassed predetermined separating force value.

Referring now to Figure 37 A-39,, can insert apparatus 600 ' ' ' be configured to according to handle member 906 with respect to anchor log shell 634 ' ' ' lengthwise position do at least two kinds of different mode of operation.For example, in accordance with the embodiments illustrated, insert apparatus 600 ' ' ' initially be configured under the anchor log Eject mode, operate, wherein tension force assembly 900 is with respect to anchor log shell 634 ' ' ' be in retraction or proximal position.When tension force assembly 900 is positioned at advanced position, the interlocking component 670 that is limited by handle member 906 can with by anchor log shell 634 ' ' ' second interlocking component 670 of the complementation that limits engages.More specifically, the far-end 906b of handle member 906 is limited to the interlocking component 670 of a pair of elasticity contact pin 934 forms on the opposite side of handle member 906, contact pin 934 is arranged in the complementary interlocking component 670, this complementation interlocking component is by the anchor log shell 634 ' of a pair of groove 696 forms ' ' limit, described a pair of groove longitudinally L extends to anchor log shell 634 ' ' ' opposite side in.The far-end 934b of each contact pin 934 can limit the protuberance 936 that is configured to be contained among the corresponding complementary recess 696b, described recess is limited in the lower surface 696a of groove 696, make and to be positioned at respect to anchor log shell 634 ' when tension force assembly 900 ' ' advanced position the time, it will remain on this position, up to being enough to that protuberance 936 is applied to tension force assembly 900 from the translational force that corresponding recess 696b separates.

When tension force assembly 900 distad translation in ' when translation ' distad, pusher member 902 is at anchor log shell 634 ' ' ' with respect to anchor log shell 634 ', enter member 606 ' thereby anchor log 22 is ejected ' ' far-end 610.When tension force assembly 900 with respect to anchor log shell 634 ' ' ' distad fully during translation, insert apparatus 600 ' ' ' do in second mode of operation.

Anchor log shell 634 ' ' ' can limit the 3rd interlocking component 670, the three interlocking components be configured to make insert apparatus 600 ' ' ' do in second mode of operation.More specifically, anchor log shell 634 ' ' ' can limit the 3rd interlocking component 670 of ring-shaped groove 698 forms, the contiguous anchor log shell 634 ' of this ring-shaped groove ' ' the far-end 644b of clamper part 644 arrange, and the size of ring-shaped groove 698 is configured to and protuberance 936 can be contained in wherein.When protuberance 936 be contained in the groove 698 make insert apparatus 600 ' ' ' when operating second, under the anchor log expansion mechanism, handle member 906 is with respect to anchor log shell 634 ' ' ' rotate freely.Therefore the far-end 610b translation of ' ' when under the anchor log expansion mechanism, operating, translation member 904 can with respect to entering member 606 ' ' ', when inserting apparatus 600 ', thus tension force is applied to actuation member and anchor log is expanded in opening 25.Should be appreciated that anchor log shell 634 ' ' ' be not limited to illustrated interlocking component 670, and anchor log shell 634 ' ' ' can or limit any other suitable interlocking component as required.It is also understood that tension force assembly 900 is not limited to the illustrated geometry of its various parts, and one or more parts of tension force assembly 900 can or use as required any other suitable geometry to construct.

According to adopt inserting apparatus 600 ' ' ' the exemplary anchor member insertion process, enter member 606 ' ' ' can with awl 609 ' ' ' use, in order to form opening 25 at target anatomical position 24 places and/or will enter member 606 ' ' ' fixing with respect to target anatomical position 24, as described in other places of this paper.In case enter member 606 ' ' ' be fixed, just can use anchor log inserter assembly 604 ' ' ' anchor log 22 is inserted in the opening 25.For example, anchor log shell 634 ' ' ' shaft portion 642 can be inserted into enter member 606 ' ' ' intubate 612 in and in intubate 612, distad advance up to latch member 686 engages plate body 680, thereby with anchor log shell 634 ' ' ' with respect to entering member 606 ' ' ' fixing.Along with anchor log shell 634 ' ' ' with respect to entering member 606 ' ' ' insert fully, insert apparatus 600 ' ' ' can by making tension force assembly 900 with respect to anchor log shell 634 ' ' ' distad translation and under the anchor log Eject mode, operating, enter member 606 ' in order to anchor log 22 ejected ' ' far-end 610b and enter in the opening 25.

When anchor log 22 has been entered member 606 ' by ejection ' ' far-end 610b, and handle member 906 is with respect to anchor log shell 634 ' ' ' the feasible apparatus 600 ' that inserts of complete translation ' ' when under the anchor log expansion mechanism, operating, handle member 906 is rotatable, thereby the described translation member 904 of translation, and apply tension force to the actuating strand 38 of anchor log.When the size of tension force reached the predetermined release force of translation member 904, the proximal body portion 910a of translation member 904 and distal body portion 910b can be separated from one another, discharged from tension force assembly 900 thereby will activate strand 38.

During the rotation of handle member 906, can along with the direction of the revolving force that is applied to handle member 906 roughly relative direction revolving force is applied in the contact pin 676 at least one, to prevent anchor log inserter assembly 604 ' ' ' parts with respect to 24 rotations of target anatomical position.When anchor log 22 has expanded in opening 25 and fixedly the time, can be with anchor log inserter assembly 604 ' ' ' parts remove from target anatomical position 24.

Totally referring to Figure 40 A-43, there is shown the alternative embodiment that is configured to as the translation member of fusion components now.More specifically, first alternative translation member 1000 has been shown among Figure 40 A.In accordance with the embodiments illustrated, translation member 1000 defines two parts translation member main body 1002, and this main body comprises the base body part 1002b that is configured to hold insertion main part 1002a.Insert main part 1002a and can limit a pair of elastic nip 1004, each jaw 1004 at least one tooth 1006 of carrying, this tooth 1006 is configured to relative to each other join, and is captured in therebetween releasedly thereby will activate strand 38.Insert main part 1002a and can limit shearing flange 1008, shearing flange 1008 is configured to when the size of the tension force that is applied to translation member 1002 surpasses predetermined release stress intensity, cut the shearing flange by base body part 1002b from inserting main part 1002a, make that inserting main part 1002a discharges from base body part 1002b.When insertion main part 1002a discharged from base body part 1002b, elastic nip 1004 was separable, activated strand 38 thereby discharge.Insert the coupling member that main part 1002a also can limit a pair of protuberance 1012 forms, protuberance 1012 be configured to the complementary coupling member that limits with handle member 906 for example helicla flute 920 cooperate.

Referring now to Figure 40 B,, shows another alternative translation member 1100.In accordance with the embodiments illustrated, translation member 1100 defines two parts translation member main body 1102, and described main body comprises the base body part 1102a that is configured to hold insertion main part 1102b.Insert main part 1102b and can limit a pair of elastic nip 1104, each jaw 1104 at least one tooth 1106 of carrying, this tooth 1106 is configured to relative to each other cooperate, and is captured in therebetween releasedly thereby will activate strand 38.Main body 1102 can limit bore hole 1108, and this bore hole extends through at least a portion of base body part 1102a and extends to and inserts among the main part 1102b.Translation member 1100 can comprise shear pin 1110, the size of this shear pin is configured to be inserted in the bore hole 1108, and be configured to when the size of the tension force that is applied to translation member main body 1102 surpasses predetermined release stress intensity, this shear pin is cut between insertion main part 1102b and base body part 1102a, makes that inserting main part 1102b discharges from base body part 1102a.When insertion main part 1102b discharged from base body part 1102a, elastic nip 1104 was separable, activated strand 38 thereby discharge.Insert the coupling member that main part 1102b also can limit a pair of protuberance 1112 forms, protuberance 1112 be configured to the complementary coupling member that limits with handle member 906 for example helicla flute 920 cooperate.

Referring now to Figure 41 A-B,, shows another alternative translation member 1200.In accordance with the embodiments illustrated, translation member 1200 defines two parts translation member main body 1202, and this main body comprises and being configured to basically around the base body part 1202a that inserts main part 1202b.Insert main part 1202b and can limit a pair of elastic nip 1204, each jaw 1204 at least one tooth 1206 of carrying, this tooth 1206 is configured to relative to each other join, and is captured in therebetween releasedly thereby will activate strand 38.Base body part 1202a can limit and shear flange 1208, this shearing flange 1208 is configured to when the size of the tension force that is applied to translation member main body 1202 surpasses predetermined release stress intensity, cut this shearing flange by inserting main part 1202b from base body part 1202a, make that inserting main part 1202b discharges from base body part 1202a.When insertion main part 1202b discharged from base body part 1202a, elastic nip 1204 was separable, activated strand 38 thereby discharge.Insert the coupling member that main part 1202b also can limit a pair of protuberance 1212 forms, protuberance 1212 be configured to the complementary coupling member that limits with handle member 906 for example helicla flute 920 cooperate.

Referring now to Figure 42,, shows another alternative translation member 1300.In accordance with the embodiments illustrated, translation member 1300 defines two parts translation member main body 1302, and this main body comprises the base body part 1302a that is configured to hold insertion main part 1302b.Base body part 1302a can limit spherical pit 1304, and the complementary spherical component 1306 that this pit is configured to be attached to cervical region 1308 is contained in wherein, and cervical region 1308 extends from inserting main part 1302b.Spherical pit 1304 can be configured to spherical component 1306 is contained in the elasticity ball-and-socket, this ball-and-socket and actuation member 38 pressure fitted that are captured in releasedly therebetween.The stickiness of spherical component 1306 in spherical pit 1304 can be adjusted into feasible size when the tension force that is applied to translation member main body 1302 surpasses when being scheduled to discharge stress intensity, spherical component 1306 discharges from spherical pit 1304, activates strand 38 thereby discharge.Insert the coupling member that main part 1302b also can limit a pair of protuberance 1310 forms, protuberance 1310 be configured to the complementary coupling member that limits with handle member 906 for example helicla flute 920 cooperate.

Referring now to Figure 43,, shows another alternative translation member 1400.In accordance with the embodiments illustrated, translation member 1400 limits two parts translation member that comprises distal body portion 1402 and proximal body portion 1404, distal body portion 1402 limits the bore hole 1406 that passes wherein, and the size of this bore hole 1406 is configured to and at least a portion of proximal body portion 1404 can be contained in wherein.Proximal body portion 1404 also can limit at least one (for example a plurality of) elastic leg 1408 that distad extends from proximal body portion 1404, this shank 1408 limits corresponding far-end 1408b, this far-end assembles to limit head 1410, the cross sectional dimensions of described head is greater than the cross sectional dimensions of the far-end 1408b of the convergence of shank 1408, and the size of head 1410 is configured to be arranged in the bore hole 1406 under pressure fitted.Each shank far-end 1408b also can limit at least one tooth 1412, and this tooth 1412 is configured to relative to each other join, and is captured in therebetween releasedly in order to will activate strand 38.

Distal body portion 1402 also can limit the coupling member of a pair of protuberance 1414 forms, protuberance 1414 be configured to the complementary coupling member that limits with handle member 906 for example helicla flute 920 cooperate.Translation member 1400 also can comprise spring 1416, this spring 1416 is separately positioned between proximal body portion 1402 and the distal body portion 1404, and spring 1416 be configured to make proximal body portion 1402 and distal body portion 1404 longitudinally L offset with respect to each.

In operation, when translation member 1400 with respect to entering member 606 ' ' ' the translation of far-end 610b proximad the time, distal body portion 1402 along with respect to be applied to by proximal body portion 1404 activate strand 38 tension force basically opposite direction spring is applied power.The power that is applied by spring can be adjusted into and make when the tension force size that is applied to distal body portion 1402 surpasses predetermined release stress intensity, head 1410 will be extruded the far-end of distal body portion 1402, thereby allow the far-end 1408b of shank 1408 relative to each other flexiblely to stretch, and discharge actuating strand 38.

Referring to Figure 44 A-C, show anchor clamps 1500, these anchor clamps are configured to actuation member 38 for example is fixed on the translation member, such as above-mentioned translation member 704,804.In accordance with the embodiments illustrated, anchor clamps 1500 comprise cylindrical fixture main body 1502.Jig main body 1502 can limit at least one radial slit 1504, and the size of this radial slit is configured to and at least a portion of actuation member 38 can be contained in wherein.Shown in jig main body define the radial slit 1504 of a pair of interconnection.In accordance with the embodiments illustrated, can place this to first slit 1504 of slit radially by the first with actuation member 38, then the second portion of actuation member 38 is placed remaining slit 1504 and will shown in actuation member 38 be fixed in the anchor clamps.

Referring now to Figure 45,, insertion apparatus 2000 according to alternative embodiment structure is configured at least one anchor log main body, and for example the first anchor log main body 28a of anchor log 22a and 22b and the second anchor log main body 28b(are referring to Figure 1A) be delivered to corresponding target anatomical structure 24(referring to Figure 1A).In accordance with the embodiments illustrated, anatomical structure 24 can be bone or any alternative anatomical structure as required.For example, described bone can be cortical bone, spongiosa part, medullary canal or their any combination.Therefore, the anchor log main body can be injected in the cortical wall of bone, inject in the spongiosa part of bone (with cortical wall spaced apart or against cortical wall), and when bone was long bone, anchor log 22a-b can be injected in the medullary canal of long bone.

Insert apparatus 2000 be shown as longitudinally axis 2002(its basically longitudinally L extend) elongation, and limit near-end 2004 and longitudinally axis 2002 and near-end 2004 isolated relative far-ends 2006.Therefore, should be appreciated that term " distally " and " nearside " with and derivative words refer to the dimensional orientation of more close far-end 2006 and near-end 2004 respectively.In addition, direction term " towards the distally " and " towards nearside " and derivative words thereof refer to 2006 downstream directions that extend from near-end 2004 towards far-end respectively, and the updrift sides of 2004 extensions from far-end 2006 towards near-end.Insert apparatus 2000 further along being substantially perpendicular to the side direction A of vertical L and being substantially perpendicular to vertical L and the horizontal T extension of side direction A.Except as otherwise noted, otherwise term " outwards " and " inwardly " and derivative words thereof refer to respectively away from direction towards longitudinal axis 2002.

Insert apparatus 2000 and comprise shell 2007, described shell can comprise first or inside subject 2008 and second or outer body 2010.In accordance with the embodiments illustrated, inside subject 2008 is supported by outer body 2010, or is at least partially disposed in the outer body 2010.For example, inside subject 2008 can be supported slidably by outer body 2010, makes inside subject 2008 to slide with respect to outer body 2010 proximads and distally.Inside subject 2008 is configured to form opening 23 at corresponding 24a-b place, target location, and described target location is configured to hold respectively anchor log main body 28a and 28b.Outer body 2010 comprises the member that enters that limits far-end 2014, for example, intubate 2012, described far-end is configured to optionally be inserted at least in part in the opening 23 of corresponding target location 24a and 24b.Intubate 2012 also is configured to anchor log main body 28a and 28b are sprung in the respective openings 23 in the corresponding anatomical structure 24.

Insert apparatus 2000 and also comprise anchor log shell 2015, this anchor log shell can be configured to anchor log box 2016, this anchor log box is supported by shell 2007 such as outer body 2010, and be configured to carry releasedly at least a portion of anchor log 22a and 22b, for example anchor log main body 28a and 28b.Box 2016 can be supported movingly by outer body 2010, in order to optionally the first anchor log main body 28a and the second anchor log main body 28b are alignd with intubate 2012.Inside subject 2008 comprises that the pusher member 2022(that operationally aligns with intubate 2012 is referring to Figure 46), make that pusher member 2022 is configured to insert by intubate 2012.For example, according to illustrated embodiment, pusher member 2022 is configured to be driven through box 2016, and bias force is applied to the anchor log of alignment, in order to the anchor log of alignment is ejected and goes out from the far-end 2014 of intubate 2012 from box 2016.

Insert apparatus 2000 and also can comprise tension force assembly 2020, this tension force assembly is by for example outer body 2010 supports of shell 2007, and at least one or both that are configured to releasedly and optionally be attached among corresponding actuating strand 38a and the 38b go up (referring to Figure 1A), and predetermined tension characteristic is applied to attached actuating strand, in order to aforesaid way corresponding anchor log main body is actuated to its expanded configuration from its first configuration.For example, predetermined tension characteristic can be at least in part limited by the predetermined travel distance of tension force assembly 2020, this makes tension force assembly 2020 with the stretching actuation force optionally, for example be applied to first individually and activate strand 38a and the second actuating strand 38b, thereby corresponding anchor log main body 28a and 28b are actuated to its corresponding expanded configuration from its corresponding first configuration.

Now inside subject 2008, outer body 2010, anchor log shell 2015 and tension force assembly 2020 will be described in more detail.

Particularly, referring to Figure 46-48C, inside subject 2008 defines near-end 2008a and relative far-end 2008b, and comprises that pusher member 2022 and retractable opening form member 2024.For example, opening form member 2024 with respect to pusher member 2022 first or advanced position (Figure 47 C) with second or extended position (Figure 48 C) between move.Thereby, inside subject 2008 comprises actuator 2009, this actuator be configured to opening form the corresponding primary importance (Figure 47 C) of the advanced position of member 2024 and and opening form motion releasedly between the corresponding second position (Figure 48 C) of the extended position of member 2024.Thereby when actuator 2009 moved between primary importance and the second position, actuator 2009 made opening form member 2024 and moves between advanced position and extended position equally.

Pusher member 2022 defines near-end 2022a and relative far-end 2022b, and opening formation member 2024 defines near-end 2024a and relative far-end 2024b.As will be described in more detail below, when opening formation member 2024 was positioned at advanced position, far-end 2024b was arranged on nearside with respect to the far-end 2022b of pusher member 2022.Therefore, the far-end 2022a of pusher member 2022 limits the far-end 2008b of inside subject 2008, and is configured to the anchor log main body is released outer body 2010.When opening formation member 2024 was positioned at extended position, far-end 2024b was arranged on the distally with respect to the far-end 2022a of pusher member 2022, thereby limited the far-end 2008b of inside subject 2008.Therefore, the opening far-end 2024b that forms member 2024 is configured in the target location 24 places and forms opening 23(referring to Figure 1A-B).

Pusher member 2022 can comprise push rod main body for example intubate 2026 and the shank 2028 that extends from intubate 2026 proximads.For example, intubate 2026 can limit the near-end 2026a that is attached to shank 2028, and the far-end 2026b that can limit the far-end 2022b of pusher member 2022.Shank 2028 can limit the near-end 2004 that inserts apparatus 2000.According to illustrated embodiment, shank 2028 can comprise cervical region 2029 and at least one (for example a pair of) on relative side direction A from cervical region 2029 extended outside grip surface 2030.This outside grip surface 2030 is configured to when carrying out translation with respect to 2010 pairs of inside subject of outer body 2008, and when activating opening formation member 2024 between advanced position and extended position, is for example manually engaged by user.Should be appreciated that shank 2028 can for example integrally or discretely be attached to intubate 2026.According to illustrated embodiment, pusher member 2022 comprises that attachment members 2032 for example sells, at least a portion that this attachment members extends laterally across shank 2028 is cervical region 2029 for example, and enters among the near-end 2026a of intubate 2026, so that shank 2028 is attached to intubate 2026 regularly.Pusher member 2022 can limit for example slit 2034 of first engagement member, and this first engagement member is for example laterally for example extending in the intubate 2026 at far-end 2026b place on the T.Slit 2034 has the length on vertical L, and this length is enough to allow opening to form member 2024 with respect to pusher member 2022 translation between advanced position and extended position.

Opening forms member 2024 and comprises the axle 2036 that limits near-end 2036a and far-end 2036b.Far-end 2036b can be convergent to limit open pointed tip 2038, this open pointed tip can be configured to awl tip, bit point of the drill, the trocar is most advanced and sophisticated or the open pointed tip of any alternative structure.The size of axle 2036 is configured to extend through at least in part the intubate 2026 of pusher member 2022, makes axle 2036 to move in intubate 2026.Opening forms member 2024 and also comprise the slide block of for example giving prominence to from axle 2,036 2040 on horizontal T, and the size of this slide block is configured to extend through the slit 2034 of pusher member 2022.Slit 2034 can limit the thickness that equates basically with the thickness of slide block 2040, makes opening form member 2024 and is limited at least or prevents with respect to pusher member 2022 rotations.Open pointed tip 2038 can be arranged on the distally with respect to slide block 2040.

As mentioned above, inside subject 2008 comprises actuator 2009, and this actuator is moving between primary importance and the second position so that opening formation member 2024 moves between advanced position and extended position respectively.According to illustrated embodiment, opening forms member 2024 and comprises first actuator means 2042 of extending from the near-end 2036a of axle 2036.For example, first actuator means 2042 comprises first locking component of actuator body 2044 and latch member form, and this latch member is configured to from actuator body 2044 extended contact pin 2046.Pusher member 2022 limits second actuator means 2048, and this second actuator means is configured to optionally cooperate in corresponding primary importance and the second position with first actuator means 2042.According to illustrated embodiment, second actuator means 2048 comprises second locking component that catches component form, and this seizure member is configured to by pusher member 2022 pit 2050 that limits of shank 2028 for example.The size of this pit is configured to hold contact pin 2046.

Pit 2050 comprises first or portions of proximal 2050a, second or distal part 2050b and the vertical elongated mid portion 2050c that extends between portions of proximal 2050a and distal part 2050b.Portions of proximal 2050a and distal part 2050b for example are offset from middle part 2050c along side direction L, and can be in alignment with each other.The size of portions of proximal 2050a and distal part 2050b and mid portion 2050c is configured to hold contact pin 2046, make contact pin 2046 to move to mid portion 2050c from portions of proximal 2050a, and can move to distal part 2050b from middle part 2050c.Contact pin 2046 also can move to mid portion 2050c from distal part 2050b, and can move to portions of proximal 2050a from middle part 2050c.

Contact pin 2046 is communicated with slide block 2040 machineries, make the contact between slide block 2040 and the intubate 2026 form spring force, this spring force can be torsion, and this spring force makes contact pin 2046 biasings, with along from middle part 2050c towards portions of proximal 2050a with the direction of distal part 2050b rotation or lateral movement, and when contact pin 2046 stops the rotation of axle 2036 when portions of proximal 2050a and distal part 2050b move to the mid portion 2050c, and make axle 2036 biasing rotations, so that contact pin 2046 also optionally enters portions of proximal 2050a and the distal part 2050b from middle part 2050c motion.Torsion can depend on the rigidity of axle 2036 and the longitudinal length between slide block 2040 and the contact pin 2046 at least in part.Thereby inside subject 2008 can limit the spring member that actuator 2009 is biased to primary importance and the second position.As shown in the figure, this spring member can be in aggregates with pusher member 2022 and opening formation member 2024, it maybe can be independent structure, make that this spring member is configured to optionally the mid portion 2050c of contact pin 2046 from pit 2050 is biased to portions of proximal 2050a and the distal part 2050b when contact pin 2046 is alignd with portions of proximal 2050a and distal part 2050b respectively.

Now especially referring to Figure 47 A-C, when contact pin 2046 is arranged among the portions of proximal 2050a of pit 2050, actuator 2009 is locked in primary importance releasedly, thus, axle 2036 far-end 2036b and open pointed tip 2038 are recessed or be arranged on nearside with respect to the far-end 2026b of the intubate 2026 of pusher member 2022.Therefore, the far-end 2026b of intubate 2026 limits the far-end 2008b of inside subject 2008.Can contact pin 2046 be biased to mid portion 2050c from the portions of proximal 2050a of pit 2050 in the direction of the effect lower edge of the spring force that is limited by the joint between slide block 2040 and the intubate 2026 arrow 2052.Then, the distally bias force can be applied to contact pin 2046 along the direction of arrow 2054, the second position that this makes contact pin 2046 extremely align with distal part 2050b from the primary importance distal motion of aliging with portions of proximal 2050a along mid portion 2050c, thus make actuator 2009 repeat to get back to primary importance.When contact pin 2046 was advanced along mid portion 2050c, slide block 2040 was advanced along slit 2034.

Referring now to Figure 48 A-C,, spring force can bias to contact pin 2046 among the distal part 2050b of pit 2050, makes actuator 2009 be locked in the second position releasedly.When contact pin 2046 was arranged among the distal part 2050b of pit 2050, the far-end 2036b of axle 2036 and open pointed tip 2038 were extended with respect to the far-end 2026b of the intubate 2026 of pusher member 2022 or are arranged on the distally.Therefore, open pointed tip 2038 limits the far-end 2008b of inside subject 2008.Can contact pin 2046 be biased to mid portion 2050c from the distal part 2050b of pit 2050 in the direction of the effect lower edge of the spring force that is limited by the joint between slide block 2040 and the intubate 2026 arrow 2052.Then, nearly the side bias force is applied to contact pin 2046 along the direction of arrow 2058, the second position that this makes contact pin 2046 extremely align with portions of proximal 2050a from the primary importance proximal motion of aliging with distal part 2050b along mid portion 2050c, thus make actuator repeat to get back to primary importance.Spring force can bias to contact pin 2046 among the portions of proximal 2050b, so that in primary importance lock actuator 2009 releasedly.

Should be appreciated that actuator 2009 can construct according to any suitable alternative embodiment as required.For example, though first actuator means 2042 of opening formation member 2024 is configured to second actuator means 2048 of latch member and pusher member 2022 and is configured to aforesaid seizure member, but opening forms first actuator means 2042 of member 2024 and can or be constructed to catch member, and second actuator means 2048 of pusher member 2022 can or be constructed to latch member.

Refer again to Figure 45, outer body 2010 comprises supporting member 2060 and enters member that this enters member and is configured the intubate 2012 that conduct is distad extended from supporting member 2060.Supporting member 2060 also can comprise shank 2059.Shown in Figure 51 A, supporting member 2060 comprises first or upper support member part 2060a and be configured to be attached to second or the lower support member part 2060b of upper support member part 2060a.The wherein one or both of supporting member part 2060a-b can limit along at least a portion of the intubate 2011 of the longitudinal length extension of supporting member 2060.Intubate 2011 is alignd with the intubate 2012 of outer body 2010.Therefore, intubate 2011 can be called as first or nearside intubate of outer body 2010, and intubate 2012 can be called as second or distally intubate of the outer body 2010 of aliging with first intubate 2011.The size of the intubate 2012 of outer body 2010 is configured to hold the intubate 2026 of pusher member 2022.Outer body 2010 also limits slit 2034, and this slit for example extends in the intubate 2012 at horizontal T.The size of slit 2034 is configured to hold the slide block 2040 that opening forms member 2024, makes inside subject 2008 be rotatably fixed to basically on the outer body 2010 with respect to relative rotary motion.For example, engaging between the axle 2036 torsionspring power that limit and the slide block 2040 that forms member 2024 by opening and the slit 2034 prevented inside subject 2008 rotatablely moving with respect to outer body 2010.Outer body also limits pit 2013, and this pit for example passes wherein along side direction A and extends at least in the supporting member 2060.The size of pit 2013 is configured to accommodation box 2016, make box 2016 with respect to particularly outer body 2010 motions of shell 2007, in order to the first anchor log main body 28a and the second anchor log main body 28b are optionally alignd with the pusher member 2022 of inside subject 2008 and the intubate 2012 of outer body 2010.

Referring now to Figure 49 A-B,, box 2016 comprises box shell 2064, and the position that this box shell is configured between first intubate 2011 and second intubate 2012 is supported on the pit 2013(of outer body 2010 referring to Figure 50 A) in.Box shell 2064 can limit at least one container, and such as a plurality of container 2066a-c, described container longitudinal extension passes this box shell 2064.The first container 2066a is configured to keep one among anchor log main body 28a and the 28b, and keeps this first anchor log main body 28a during operation according to illustrated embodiment.The second container 2066b outwards arranges with respect to the first container 2066a side direction, and is configured to keep other among anchor log main body 28a and the 28b, and thereby keeps the second anchor log main body 28b during operation according to illustrated embodiment.Be to be understood that, box 2016 can comprise the required a plurality of containers that are configured to keep corresponding anchor log main body, make that inserting apparatus 2000 is configured to optionally the anchor log main body that keeps is pushed to corresponding target location, and in mode as herein described the anchor log that ejects is actuated to its expanded configuration subsequently.Container 2066a-c also comprises the 3rd or empty 2066c, the 3rd or empty be the empty that inwardly arranges with respect to the first container 2066a side direction, and its size can be configured to hold one of anchor log main body 28a and 28b, but does not in fact keep the anchor log main body during operation according to illustrated embodiment.The first container 2066a is arranged between the second container 2066b and the empty 2066c.

As from following description, will be understood that, box 2016 moves to primary importance from initial position, and move to the second position, at initial position, empty 2066c aligns with intubate 2012, and in primary importance, first container 2066 and the first anchor log main body 28a that keeps align with intubate 2012, in the second position, the second anchor log main body 28b of the second container 2066b and maintenance aligns with intubate 2012.When empty 2066c aligns with intubate 2012, the intubate 2026 of pusher member 2022 can translate across empty 2066c and further pass intubate 2012, makes the open pointed tip 2038 of inside subject 2008 can form first opening that is configured to hold the first anchor log main body 22a in first target location.When the first container 2066a aligns with intubate 2012, the intubate 2026 of pusher member 2022 can translate across the first container 2066a and further pass intubate 2012, make pusher member 2022 can make the first anchor log main body 28a pass box 2016 and intubate 2012 biasings, and enter in first opening that forms in first target location.In some alternative embodiment, box 2016 can save empty 2066c, and box 2016 can be attached to outer body 2010, make inside subject 2008 after first target location forms first opening first container 2066a align with intubate 2012.

Be to be understood that, in case the first anchor log main body 28a removes from the first container 2066a, then this first container 2066a limits the empty of the intubate 2026 that can hold pusher member 2022, the open pointed tip 2038 of inside subject 2008 make pusher member 2022 pass intubate 2012 further translations, to such an extent as to can form second opening that is configured to hold the second anchor log main body 22b in second target location.When the second container 2066b aligns with intubate 2012, pusher member 2022 can be passed the second container 2066b and further be passed intubate 2012 translations, make pusher member 2022 can make the second anchor log main body 28b pass box 2016 and intubate 2012 biasings, and enter in second opening that forms in second target location.

Box 2016 also can comprise backstop folder 2068, and this backstop folder is attached to box shell 2064 releasedly, and outwards arranges with respect to the first container 2066a side direction.For example, backstop folder 2068 can comprise a pair of arm 2069, and described arm extends and is configured to be clipped on the end relatively of box shell 2064 from base portion 2071.This backstop folder 2068 is configured to when the first container 2066a and intubate 2012 are alignd to be conducive to the first container 2066a and alignd with intubate 2012, and this backstop is pressed from both sides 2068 latch housings 2007, is in particular outer body 2010.Backstop folder 2068 can remove from box shell 2064, moves in order to the second container 2066b is alignd with intubate 2012 along side direction A with respect to outer body 2010 to allow box 2016.Backstop folder 2068 can comprise pull tab 2070, this pull tab can for example manually engage in case with one of arm 2069 from the engaging of box shell 2064 remove, properly remove from box shell 2064 thereby backstop folder 2068 is met ergonomically.

Now specifically referring to Figure 49 B, the first anchor log 22a and the second anchor log 22b comprise the first anchor log main body 28a and the second anchor log main body 28b that remains on respectively among the first container 2066a and the second container 2066b, and are attached to corresponding anchor log main body 28a and the corresponding actuating strand 38a-b of 28b.Activate strand 38a and 38b can be integrally with each other limiting shared strand, or can be attached to one another separated from one another and on demand.For example, every activates strand 38a and 38b can comprise corresponding actuation part 131a and 131b and corresponding attachment part 133a and 133b.Attachment part 133a and 133b both can integrally be attached to one another, also can be separated from one another and attached with required any way.Though each anchor log 22a and 22b are shown as including single corresponding actuating strand 38a and the 38b attached with corresponding anchor log main body 28, but should be appreciated that anchor log 22a and 22b can comprise that being attached to anchor log main body 28a and 28b required many with any way as herein described activates strand 38a and 38b.For example, each anchor log 22a and 22b can comprise a pair of corresponding actuating strand 38a and the 38b that is attached to anchor log main body 28a and 28b respectively.

Box 2016 also can comprise the jar 2072 supported with respect to box shell 2064, and the guidance set 2074 supported with respect to jar 2072 and box shell 2064.For example, jar 2072 can be attached to box shell 2064, and guidance set 2074 can be attached to jar 2072.According to illustrated embodiment, box shell 2064, jar 2072 and guidance set 2074 are integrally with each other.Guidance set 2074 can be arranged on nearside and substantially vertically aligns with box shell 2064 with respect to box shell 2064, makes box 2016 define the space 2076 of longitudinal extension between box shell 2064 and guidance set 2074.Guidance set 2074 comprises that base portion 2078 and at least one lead tooth 2080, for example a plurality of teeth 2080 of leading that extend from base portion 2078.

According to illustrated embodiment, the actuation part 131a of the actuating strand 28a of the first anchor log 22a and attachment part 133a distad extend leading between the tooth 2080 of first pair of vicinity, around this first pair of vicinity lead tooth 2080, and extend and enter in jars 2072 at the proximad of leading between the tooth 2080 of second pair of vicinity.Similarly, the actuation part 131b of the actuating strand 38b of the second anchor log 22b and attachment part 133a distad extend leading between the tooth 2080 of the 3rd pair of vicinity, around the 3rd pair of vicinity lead tooth 2080, and extend and enter in jars 2072 at the proximad of leading between the tooth 2080 of the 4th pair of vicinity.Should be appreciated that this first couple leads tooth, second pair and leads tooth, the 3rd pair and lead tooth and the 4th pair and lead tooth 2080 and can comprise shared one of the tooth 2080 of leading.It is also understood that jar 2072 is configured to actuating strand 38a and the 38b that keeps extra releasedly.Extra attachment part 133a and 133b can have enough length to allow there are enough gaps during referring to Figure 1A-B) betwixt as the first anchor log main body 28a and the implanted corresponding target location 24a-b(of the second anchor log main body 28b.Should be appreciated that inserting apparatus 2000 can comprise the anchor log 22a-b that is pre-loaded onto in the box 2016.In addition, box 2016 can be set to and insert apparatus 2000 and separate, and makes carrying case 2016 before use, or can be as required by shell 2007 supporting case permanently.

Now the operation of box 2016 will be described in conjunction with Figure 50 A-H.Referring to Figure 50 A, box 2016 is positioned at the initial position that empty 2066c aligns with first intubate 2011 and second intubate 2012 especially, makes that the part of inside subject is extensible to pass empty 2066c and pass second intubate 2012.Opening form the open pointed tip 2038 of member 2024 can be in the above described manner to the distal extension of intubate 2026, to form first opening in first target location.For example, the intubate 2026 of pusher member 2022 is extensible passes first intubate 2011, passes empty 2066c and passes second intubate 2012.The open pointed tip 2038 that opening forms member 2024 can be positioned at aforesaid extended position, to form first opening in first target location.

Secondly, shown in Figure 50 B, the intubate 2026 of pusher member 2022 can retract to the proximal position of pit 2013, and open pointed tip 2038 can bounce back, and makes the far-end 2026b of intubate 2026 limit the far-end 2008b of inside subject 2008.Shown in Figure 50 C, box shell 2064 can be with respect to shell 2007, for example lateral translation is to primary importance with respect to the inside subject 2008 in the pit 2013 and outer body 2010 particularly, and wherein the first container 2066a and the first anchor log main body 28a and first intubate 2011 and second intubate 2012 and pusher member 2022 are alignd.When the first container 2066a is positioned at primary importance, backstop folder 2068 can with box shell 2064 adjacency.Shown in Figure 50 D, the intubate 2026 that can drive pusher member 2022 is passed the first container 2066a, makes intubate 2026 that the first anchor log main body 22a is passed second intubate 2012 and distad setovers, and enter into first opening of formation.Then, open pointed tip 2038 can extend to limit the far-end 2008b of inside subject 2008 again, and can form second opening in second target location.Alternatively, when intubate 2026 extends through empty 2066c, and when box shell 2064 was positioned at initial position shown in Figure 50 A, open pointed tip 2038 can form second opening.

Referring now to Figure 50 E,, in case the first anchor log main body 28a has been ejected and second opening forms, then opening formation member 2024 can bounce back again, makes open pointed tip 2038 be arranged on the nearside of pit 2013 as mentioned above.Open pointed tip 2038 can bounce back, and makes the far-end 2026b of intubate 2026 limit the far-end 2008b of inside subject 2008.Shown in Figure 50 F, backstop folder 2068 can remove from box shell 2064.Referring to Figure 50 G, box shell 2064 can be with respect to shell 2007, for example lateral translation is to the second position with respect to the inside subject 2008 in the pit 2013 and outer body 2010 particularly, and wherein the second container 2066b and the second anchor log main body 28b and first intubate 2011 and second intubate 2012 and pusher member 2022 are alignd.Shown in Figure 50 H, the intubate 2026 that can drive pusher member 2022 is passed the second container 2066b, makes intubate 2026 that the second anchor log main body 22b is passed second intubate 2012 and distad setovers.

Referring now to Figure 51 A-D,, insert apparatus 2000 and also can comprise tension force assembly 2020, this tension force assembly is configured to releasedly and optionally be attached to corresponding actuating strand 38a and 38b, and for example when user drives, predetermined tension characteristic is applied to actuating strand 38a and 38b, and this makes corresponding anchor log main body 28a and 28b extend to its corresponding expanded configuration from its first corresponding configuration.Tension force assembly 2020 comprises and grasps assembly 2021 and motion assembly 2023, describedly grasp actuating strand 38a and the 38b that assembly 2021 is configured to engage optionally and releasedly anchor log 22a and 22b, and described motion assembly 2023 be configured to grasp assembly 2021 from primary importance motion preset distance to the second position, this makes and grasps assembly 2021 and the stretching actuation force is applied to respectively activates strand 38a and 38b.Tension force assembly 2020, especially motion assembly 2023 can comprise the actuator that can be configured to lever 2082, described lever restriction first or near-end 2082a and second relative or far-end 2082b.Near-end 2082 for example is configured to be pivotally connected to outer body 2010 at joint 2017 places of the proximal position that is arranged at pit 2013.According to illustrated embodiment, motion assembly 2023 also comprises first pivot member such as first pivot pin 2083, this first pivot member extends among the far-end 2082b of outer body 2010 and lever 2082 at least, and is limited to first pivot axis 2084 that side direction A goes up extension.As describing in more detail hereinafter, lever 2082 is configured to pivot around first pivot axis 2084, with with tension force assembly 2020 from first or break away from configuration and be actuated into second or engagement configuration and to the 3rd or the tensioning configuration, under first configuration, grasp assembly 2021 and be not attached to one of actuating strand 38a and 38b, under second configuration, grasp assembly 2021 and (for example optionally be attached to one of actuating strand 38a and 38b, grasp assembly can be individually rather than side by side be attached to activate strand 38a and 38b), under the 3rd configuration, grasp assembly 2021 tension force is applied to one of the attached actuating strand 38a of selectivity and 38b, thereby corresponding anchor log main body 28a or 28b are urged to its expanded configuration from its first configuration.

Motion assembly 2023 also can comprise force transmitting member, and for example arm 2086, and described arm limits first or near-end 2086a and second or far-end 2086b.Arm 2086 can be configured to a pair of pillar 2087 that is spaced apart from each other along side direction A.The far-end 2086b of arm 2086 is configured to be pivotally connected to lever 2082 at joint 2085 places.According to illustrated embodiment, motion assembly 2023 comprises second pivot member, second pivot pin 2088 for example, this second pivot member extend to lever 2082 and at least in the outer body arm 2086 at near-end 2086a place, and define second pivot axis 2090 that extends at side direction A.As describing in more detail hereinafter, arm 2086 is configured to pivot around pivot axis 2084, when activating towards the tensioning configuration from breaking away from configuration with convenient lever 2082 with the translation of near-end 2086a proximad.As describing in more detail hereinafter, the near-end 2086a of arm 2086 limits cam member 2090, and this cam member is configured to make 2020 biasings of tension force assembly between disengaging configuration and engagement configuration.This cam member 2090 for example limits the outer cam surface 2091 by at least one or both carryings of fork 2087.

Continuation is referring to Figure 51 A-D, grasp assembly 2021 and comprise first engagement member 2081, for example be configured first gripping member 2090 as breech lock 2092, this breech lock define first or outer end 2092a and with first terminal 2092a isolated second or the inner 2092b.The first terminal 2092a is configured to be pivotally connected to arm 2086 at joint 2089 places.According to illustrated embodiment, tension force assembly 2020 comprises the 3rd pivot member, the 3rd pivot pin 2094 for example, the 3rd pivot member for example extends in the breech lock 2092 at least at first terminal 2092 places, and for example further extends in the arm 2086 at far-end 2086b place in the position of contiguous cam member 2090.For example, the near-end 2092 of breech lock 2092 can be arranged on 2087 on adjacent pillar, and the 3rd pivot pin 2094 extensible first terminal 2092a and the pillars 2087 that pass breech lock 2092.The 3rd pivot pin 2094 is in side direction A extension and limit the 3rd pivot axis 2096.According to illustrated embodiment, outer cam surface 2091 arranges prejudicially with respect to the 3rd pivot axis 2096.Therefore, be to be understood that, the connection that is pivoted relative to each other of lever 2082, arm 2086 and breech lock 2092, first pivot axis 2084, second pivot axis 2090 and the 3rd pivot axis 2096 can be parallel to each other basically, make lever 2082, arm 2086 and breech lock 2092 pivoting by horizontal T with in the common plane that vertically L limits.

Now especially referring to Figure 51 D, the first terminal 2092a of breech lock 2092 is along side direction A and vertically at least one among the L or both limit the first cross sectional dimensions D1.The first terminal 2092a can limit required Any shape.The second terminal 2092b of breech lock 2092 is along side direction A and vertically at least one among the L or both limit the second cross sectional dimensions D2.The second cross sectional dimensions D2 can be arranged essentially parallel to the first cross sectional dimensions D1, and can be greater than D1 according to illustrated embodiment.Breech lock 2092 also limits first slit 2098 that extends among the second terminal 2092b, makes breech lock 2092 comprise first composition surface 2100, and this first composition surface limits first or lower end of first slit 2098 at least in part.

Grasp assembly 2021 and also comprise second engagement member 2079, this second engagement member is configured to engage first engagement member 2081, activates strand 38a and 38b in order to catch releasedly and optionally.Second engagement member 2079 can comprise second gripping member 2102, this second gripping member can limit the member of advancing such as translation member, for example supporting member 2060 is supported slidably with respect to outer body 2010 for this member of advancing, and be configured to when motion assembly 2023 activates, with respect to far-end 2014 translations of intubate 2012.For example, second engagement member comprises the base portion 2104 that supports second gripping member 2102.Locate in the proximal position (referring to Figure 45) with respect to pit 2013, supporting member longitudinally L supports movingly towards nearside and distally, but translation ground support base 2104 for example.According to illustrated embodiment, supporting member 2060 limits at least one first ways, for example the first relative ways of a pair of side direction that is carried by supporting member 2060.The base portion 2104 of second gripping member 2102 comprises at least one second ways that cooperates with first ways, the second relative ways of a pair of side direction for example so that allow second gripping member 2102 longitudinally L with respect to outer body 2010 translations.For example, first ways can be configured to vertically elongated slit 2106, this vertical elongated slit side direction caves inward and enters the relative lateral outer 2061 of supporting member 2060.Second ways can be configured to extend to vertical elongated track 2108 slit 2106 from base portion 2104, makes track 2108 to slide in slit 2106 so that with respect to outer body 2010 proximads and distally translation second gripping member 2102.Base portion 2104 is configured in the first farthest side position, for example in stop dog component 2063 adjacency of supporting member 2060 places and outer body 2010, thereby limits the disengaging configuration of tension force assembly 2020.

Second gripping member 2102 can be configured to clip 2103, this clip limit first or outer end 2103a and with first terminal 2103a isolated second or the inner 2103b, thereby limit chamber 2110.Chamber 2110 limits the 3rd cross sectional dimensions D3, and the 3rd cross sectional dimensions extends into and is arranged essentially parallel to first cross sectional dimensions and second cross sectional dimensions, and its size is configured to be substantially equal to or is slightly larger than the second cross sectional dimensions D2.In addition, the thickness of chamber 2110 on horizontal T is greater than the thickness of the second terminal 2092b of breech lock 2092, make the second terminal 2092b with respect to clip 2103 for example along transverse translation.Clip also limits and extends through the first terminal 2103a and enter hole 2112 in the chamber 2110.Hole 2112 limits the 4th cross sectional dimensions D4, and it extends into and is arranged essentially parallel to first cross sectional dimensions, second cross sectional dimensions and the 3rd cross sectional dimensions D1-D3, and less than the 3rd cross sectional dimensions D3.For example, the 4th cross sectional dimensions D4 can be substantially equal to or be slightly larger than the first cross sectional dimensions D1 and less than the second cross sectional dimensions D2.Therefore, the first terminal 2092a of breech lock 2092 can slide in hole 2112, and the second terminal 2092b of the first terminal 2103a interference breech lock 2092 of clip 2102, passes hole 2112 to prevent that the second terminal 2092b from advancing.

Clip 2103 also limits second slit 2114, the horizontal expansion and align with chamber 2110 between the first terminal 2103a and the second terminal 2103b of this second slit.Clip 2103 comprises second composition surface 2115 that limits second slit 2114 at least in part.Second composition surface 2115 is for example along laterally relative with first composition surface 2100 of breech lock 2098, in order to limit variable-sized gap 2116, extend between first composition surface 2100 and second composition surface 2115 in described gap, as will be hereinafter described.

Continuation is referring to Figure 51 A-D, and when tension force assembly 2020 was in the disengaging configuration, second engagement member for example was positioned at the farthest side position of base portion 2104 abutment stops members 2063 at base portion 2104 places, and lever 2082 is positioned at extended position.Tension force assembly 2020 can comprise and be configured to tension force assembly 2020 is biased to the spring member 2118 that it breaks away from configuration.For example, spring member 2118 can be the torsionspring that adjacent joint 2085 arranges, and this joint is arranged between lever 2082 and the arm 2086.Spring member 2118 is setovered lever 2082 towards its extended position, and base portion 2104 is further biased to its farthest side position.When tension force assembly 2020 was in the disengaging configuration, variable-sized gap 2116 made that greater than the thickness that activates strand 38 activating strand can slide between first composition surface 2100 and second composition surface 2115.

Referring now to Figure 51 E-F,, for example can pass through actuation lever 2082, for example under the effect of the power of spring member 2118, come actuating movement assembly 2023 towards outside main body 2010 presses lever 2082, the motion of breech lock 2092 makes arm 2086 with respect to the biasing of outer body 2010 proximads, and this makes clip 2103 in the above described manner with respect to outer body 2010 proximad translations.Particularly, the near-end 2086a of arm 2086 is actuated to pivot around the 3rd pivot axis 2096, and this causes that the outer cam surface 2091 of cam member 2090 engages with the first terminal 2103a of clip 2103.When cam face 2091 was taken along the first terminal 2103a of clip 2103, the near-end 2086a of arm 2086 was away from outer body 2010 transverse movements, and this makes the 3rd pivot pin 2094 equally away from outer body 2010 transverse movements.As mentioned above, the 3rd pivot pin 2094 is attached to the first terminal 2092a of breech lock 2092.Therefore, when the 3rd pivot pin 2094 moved away from outer body 2010, the 3rd pivot pin 2094 made breech lock 2092 away from outer body 2010 motions, and this moves first composition surface 2100 and second composition surface 2115 together to.Therefore, we can say that in first composition surface 2100 and second composition surface 2115 at least one can be with respect to the motion of another composition surface, thereby reduce variable-sized gap 2116.Therefore tension force assembly 2020 is moveable to bonding station, second gripping member 2102 is spaced apart towards nearside with stop surfaces 2063 thus, and first composition surface 2100 and second composition surface 2115 comprise actuation part and attachment part with actuating strand 38() engage, be captured in the variable-sized gap 2116 thereby will activate strand 38.Therefore, activating strand 38 can be with grasping assembly 2021 towards proximal movement.

Referring to Figure 51 G-H, when lever 2082 further activated, when for example under the effect of the power of spring member 2118, further being pressed downwards towards outside main body 2010, the motion of breech lock 2092 makes arm 2086 with respect to outer body 2010 further proximad biasings, and this makes clip 2103 in the above described manner with respect to outer body 2010 further proximad translations.Particularly, the near-end 2086a of arm 2086 is actuated to further pivot around the 3rd pivot axis 2096, and this makes the outer cam surface 2091 of cam member 2090 further engage with the first terminal 2103a of clip 2103.When cam face 2091 is further taken along the first terminal 2103a of clip 2103, the near-end 2086a of arm 2086 is away from outer body 2010 further transverse movements, this makes the 3rd pivot pin 2094 equally away from outer body 2010 further transverse movements, breech lock 2092 is further moved away from outer body 2010, this pulls closer first composition surface 2100 and second composition surface 2115, and further reduce variable-sized gap 2116, this makes that activating strand 38 further is captured between first composition surface 2100 and second composition surface 2115.First composition surface 2100 and second composition surface 2115 caught activate strand after, and when grasping assembly 2021 in response to the further actuating of breech lock 2092 further during the proximad translation, tension force assembly 2020 iteration are to the tensioning configuration, grasp assembly 2021 thus the stretching actuation force is applied to activate strand 38(and comprise actuation part 131 and bonding part 133), this makes corresponding anchor log main body extend to its expanded configuration from its first configuration.

Motion assembly 2023 is configured to make and grasps assembly 2021 proximad translation preset distance between engagement configuration and stretching configuration.This preset distance of adjustable, in order to anchor log main body 28a and 28b are stretched not causing that tension force assembly 2020 is applied to unnecessary power under the situation of anchor log main body 28a and 28b, described unnecessary power can be with anchor log main body 28a and 28b along a direction setover out its corresponding target location or the structural intergrity of infringement anchor log main body 28a and 28b.Therefore, according to illustrated embodiment, the gained tension force of tension force assembly 2020 can be limited by the travel distance that grasps assembly 2021.Yet should be appreciated that and to grasp assembly 2021 according to any suitable alternative embodiment configuration as herein described, make that the predetermined tension feature of tension force assembly 2020 can be predetermined force, or the combination of predetermined force and preset distance.In case anchor log main body 28 has extended to its expanded configuration, then lever 2082 can be released, and this makes spring member 2118 that tension force assembly 2020 is biased to its disengaging configuration as mentioned above.Should be appreciated that at least one in the composition surface 2100 and 2115 or both move away from another composition surface, thereby variable-sized gap 2116 is increased to greater than the thickness that activates strand 38 when tension force assembly 2020 iteration break away from configuration to it.Then, can remove from tension force assembly 2020 activating strand.

To the operation of inserting apparatus 2000 be described in conjunction with Figure 52 A-55F now.Be to be understood that, the method step of Que Dinging needn't carry out with described order hereinafter hereinafter, unless otherwise indicated, otherwise needn't all carry out hereinafter the method step of determining the first anchor log main body 28a and the second anchor log main body 28b are implanted corresponding target location 24a and 24b.

Referring to Figure 52 A-D, insert apparatus 2000 and be configured to form the first opening 23a, this first opening is configured to hold the corresponding first knot anchor log main body 28a.For example, shown in Figure 52 A, insert apparatus 2000, for example intubate 2012, can align with the first target location 22a, and box 2016 can be positioned at initial position, make empty 2066c align with intubate 2012.Can adopt above and in conjunction with the described mode of Figure 48 A-C actuator 2009 be moved to its second position.Therefore, contact pin 2046 moves to the mid portion 2050c of pit 2050 from the portions of proximal 2050a of pit 2050 under the effect of spring force, described spring force can form the axle 2036 of member 2024 and the joint between the intubate 2026 of pusher member 2022 is limited by opening.In case contact pin 2046 is positioned at mid portion 2050c, contact pin 2046 just can distad move to the distal part 2050b positions aligning with pit, makes spring force that contact pin 2046 is biased among the distal part 2050b.When contact pin 2046 was distad advanced, axle 2036 and open pointed tip 2038 were also distad advanced.When contact pin 2046 was alignd with distal part 2050b and is arranged on wherein, actuator 2009 was positioned at the second position.When actuator 2009 is positioned at the second position and inside subject 2008 is positioned at distal position, when for example making shank 2028 in abutting connection with shank 2059, the intubate 2026 extensible empty 2066c that pass, and opening formation member 2024 is positioned at extended position, makes open pointed tip 2038 distad extend the far-end 2014 of intubate 2012.

Then, referring to Figure 52 B, open pointed tip 2038 can form the first opening 23a in the first target location 24a.For example, can strike with a hammer insert apparatus 2000 near-end 2004 so that the distally driving force is imparted on the open pointed tip 2038.Alternatively or in addition, the awl motion can be imparted to and insert on the apparatus 2002, so that the distally driving force is applied to open pointed tip 2038.Alternatively, boring motion for example can be imparted on the axle 2036 via inserting apparatus 2000, thereby and be imparted on the open pointed tip 2038, in order to the distally driving force is imparted on the open pointed tip 2038.When open pointed tip 2038 was alignd with the first target location 24a, the distally driving force made open pointed tip 2038 form the first opening 23a in the first target location 24a, made that the far-end 2014 of intubate 2012 is arranged among the first opening 23a at least.

Referring to Figure 52 C, in case the first opening 23a has been formed among the first target location 24a, then actuator 2009 can be from second position iteration to primary importance, and the far-end 2014 of intubate 2012 remains among the first opening 23a at least.In case iteration is to primary importance for actuator 2009, then open pointed tip 2038 is with respect to the far-end 2026b depression of intubate 2026.For example, as above in conjunction with as described in Figure 47 A-C, the spring force that can the joint between the axle 2036 that is formed member 2024 by opening and the intubate 2026 of pusher member 2022 limit used down, contact pin 2046 is actuated to mid portion 2050c from distal part 2050b, and proximad moves to the portions of proximal 2050a positions aligning with pit, makes spring force that contact pin 2046 is biased among the portions of proximal 2050a.In case actuator 2009 is positioned at primary importance, then opening formation member 2024 is positioned at advanced position, makes open pointed tip 2038 be arranged on the nearside of the far-end of intubate 2026b.When inside subject 2008 be positioned at its first or during distal position, the far-end of intubate 2026b may extend into the position that flushes or be positioned at its distally at least with the far-end 2014 of intubate 1012 basically, make the far-end of intubate 2026b limit the far-end that inserts apparatus 2000.

Referring to Figure 52 D, in case the first opening 23a has been formed on the first target location 24a, then inside subject 2008 can bounce back to second or proximal position, and wherein the far-end 2008b(of inside subject 2008 is referring to Figure 46) be arranged on nearside with respect to pit 2013.For example, far-end 2008b can be arranged in the intubate 2011 that is limited by supporting member 2060.Should be appreciated that actuator 2009 can be from its second position motion before or after inside subject 2008 bounces back to proximal position.

Then, referring to Figure 53 A-E, the first anchor log main body 28a that is in its first configuration can be implanted among the first opening 23a, it extends to expanded configuration subsequently.For example, shown in Figure 53 A, and described in conjunction with Figure 50 B-C as mentioned, in case inside subject 2008 is positioned at proximal position, then actuatable box 2016 is placed to the intubate 2026 of pusher member 2022 with the anchor log main body 28a with the first container 2066a and maintenance and operationally aligns.Therefore, box 2016 can laterally move to primary importance in pit 2013, thus the first container 2066a and and then the first anchor log main body 28a operationally align with pusher member 2022 and intubate 2011 and 2012.According to an embodiment, box 2016 translation laterally is up to backstop folder 2068 and shell 2007 adjacency, main body 2010 places externally for example, and at this moment, anchor log main body 28a operationally aligns with pusher member 2022 and intubate 2011 and 2012.Be to be understood that, when box 2016 is positioned at primary importance, according to illustrated embodiment, at least one first activates strand 38a(and is interpreted as that the first anchor log 22a can comprise that more than one first activates strand 38a, for example can comprise the identical opening that passes the first anchor log main body 28a as required or pass two first that different openings weaves activating strand 38a) extend through the slit 2098 that grasps assembly 2021 and 2114 and breech lock 2092 and clip 2103 respectively.

Referring now to Figure 53 B,, in case box is positioned at primary importance, pusher member 2022 just can distad move to distal position from proximal position, internals 2008 thus with external member 2010 adjacency.When pusher member 2022 distad during translation, the far-end 2026b of intubate 2026 advances along intubate 2011, enters the first container 2060a, and drives the first anchor log main body 28a and pass intubate 2012 and leave far-end 2014 and enter among the first opening 23a.As mentioned above, when pusher member was positioned at distal position, the far-end 2026b of intubate 2026 may extend into the position that flushes or be positioned at its distally with the far-end 2014 of intubate 2012 at least basically, was ejected intubate 2012 to guarantee the first anchor log main body 28a.Should be appreciated that the first actuating strand 38a keeps extending through the slit 2098 and 2114 that grasps assembly 2021.

Therefore, referring now to Figure 53 C,, and as above in conjunction with as described in Figure 51 A-51I, can be with tension force assembly 2020 from first or break away from configuration and be actuated to second or engagement configuration and be actuated to the 3rd or the tensioning configuration, under first configuration, at least one activates strand 38a and can grasp for example slip in slit 2098 and 2114 of assembly 2021, under second configuration, grasp assembly 2021 and be attached at least one actuating strand 38a that can comprise actuation part 131a and attachment part 133a, under the 3rd configuration, grasp assembly 2021 and in the above described manner the stretching actuation force is applied at least one actuating strand 38a, thereby corresponding anchor log main body 28a is actuated to its expanded configuration from its first configuration.For example, can with lever 2082 from first or the middle position be pressed into second actuated position, this makes the motion assembly will grasp assembly 2021 proximad translations, thereby activate grasp assembly with in first composition surface 2100 and second composition surface 2115 at least one with respect to another composition surface motion, thereby reduce variable-sized gap 2116.According to illustrated embodiment, first composition surface 2100 can activate strand 38a to reduce variable-sized gap 2116 and to catch at least one towards 2115 motions of second composition surface.The further actuating of motion assembly 2023 makes and grasps assembly 2021 preset distance of advancing, and the stretching actuation force is applied at least one actuating strand 38a that catches.Referring to Figure 53 D, in case the first anchor log main body 28a expand, lever 2082 just for example at spring member 2118(referring to Figure 51 A-51I) power under turn back to its middle position, as mentioned above.Shown in Figure 53 E, for example by proximal force being applied to outer body 2010 intubate 2012 is removed from the first opening 23a, will insert apparatus 2000 and remove from the first target location 24a.

In case the first anchor log main body 28a implants at 24a place, first target location and expands, just this insertions apparatus 2000 be configured in the implantation of 24b place, second target location and activate the second anchor log main body 28b, as will be in conjunction with as described in Figure 54 A-55F.For example, totally referring to Figure 54 A-D, insert apparatus 2000 and be configured to form the second opening 23b, this second opening is configured to hold the corresponding second knot anchor log main body 28b.For example, shown in Figure 54 A, insert apparatus 2000 for example intubate 2012 can align with the second target location 24b, and box 2016 can be arranged on its primary importance, makes that the first container 2066a without any the anchor log main body aligns with intubate 2012.Can adopt above and in conjunction with the described mode of Figure 48 A-C actuator 2009 be moved to its second position.Therefore, contact pin 2046 moves to the mid portion 2050c of pit 2050 from the portions of proximal 2050a of pit 2050 under the effect of spring force, described spring force can form the axle 2036 of member 2024 and the joint between the intubate 2026 of pusher member 2022 limits by opening.In case contact pin 2046 is arranged on mid portion 2050c, contact pin 2046 just can distad move to the distal part 2050b positions aligning with pit, makes spring force that contact pin 2046 is biased among the distal part 2050b.When contact pin 2046 was distad advanced, axle 2036 and open pointed tip 2038 were also distad advanced.When contact pin 2046 was alignd with distal part 2050b and is arranged on wherein, actuator 2009 was positioned at the second position.When actuator 2009 is positioned at the second position and inside subject 2008 is positioned at distal position, when for example making shank 2028 in abutting connection with shank 2059, opening forms member 2024 and is positioned at extended position, and open pointed tip 2038 is distad extended the far-end 2014 of intubate 2012 thus.

Then, referring to Figure 54 B, open pointed tip 2038 can form the second opening 23b in the second target location 24b.For example, can strike with a hammer insert apparatus 2000 near-end 2004 so that the distally driving force is imparted on the open pointed tip 2038.Alternatively or in addition, the awl motion can be imparted to and insert on the apparatus 2002 so that the distally driving force is applied to open pointed tip 2038.Still alternatively, the boring motion for example can be imparted on the axle 2036 via inserting apparatus 2000, thereby and be imparted on the open pointed tip 2038 in order to the distally driving force is imparted on the open pointed tip 2038.When open pointed tip 2038 was alignd with the first target location 24a, the distally driving force made open pointed tip 2038 form the second opening 23b in the second target location 24b, made that the far-end 2014 of intubate 2012 is arranged among the second opening 23b at least.

Referring to Figure 54 C, in case the second opening 23b has been formed among the second target location 24b, then actuator 2009 can make that the far-end 2014 of intubate 2012 remains among the second opening 23b at least from second position iteration to primary importance.In case iteration is to primary importance for actuator 2009, then open pointed tip 2038 is with respect to the far-end 2026b depression of intubate 2026.For example, as above in conjunction with as described in Figure 47 A-C, under the effect of the spring force that can limit at the joint between the intubate 2026 of the axle 2036 that is formed member 2024 by opening and pusher member 2022, contact pin 2046 is actuated to mid portion 2050c from distal part 2050b, and proximad moves to the portions of proximal 2050a positions aligning with pit, makes spring force that contact pin 2046 is biased among the portions of proximal 2050a.In case actuator 2009 is positioned at primary importance, then opening formation member 2024 is positioned at advanced position, makes open pointed tip 2038 be arranged on the nearside of the far-end of intubate 2026b.When inside subject 2008 be positioned at its first or during distal position, the far-end of intubate 2026b may extend into the position that flushes or be positioned at its distally at least with the far-end 2014 of intubate 1012 basically, make the far-end of intubate 2026b limit the far-end that inserts apparatus 2000.

Referring to Figure 54 D, in case the second opening 23b has been formed among the second target location 24b, then inside subject 2008 can bounce back to second or proximal position, and wherein the far-end 2008b(of inside subject 2008 is referring to Figure 46) be arranged on nearside with respect to pit 2013.For example, far-end 2008b can be arranged in the intubate 2011 that is limited by supporting member 2060.Should be appreciated that actuator 2009 can be from its second position motion before or after inside subject 2008 bounces back to proximal position.

Then, totally referring to Figure 55 A-F, the second anchor log main body 28b that is in its first configuration can be implanted among the second opening 23b, it extends to expanded configuration subsequently.For example, shown in Figure 55 A, and as above in conjunction with as described in Figure 50 B-C, in case inside subject 2008 is positioned at proximal position, actuatable box 2016 then is placed to the intubate 2026 of pusher member 2022 with the second anchor log main body 28b with the second container 2066b and maintenance and operationally aligns.Therefore, box 2016 can laterally move to the second position in pit 2013, thus the second container 2066b and and then the second anchor log main body 28b operationally align with pusher member 2022 and intubate 2011 and 2012.For example, shown in Figure 55 A-F, can adopt aforesaid way that backstop folder 2068 is removed from box shell 2064.

Then, referring to Figure 55 B, according to an embodiment, but box 2016 lateral translations are positioned at the second position up to box 2016, thus the second container 2066b and and then the second anchor log main body 28b operationally align with pusher member 2022 and intubate 2011 and 2012.Be to be understood that, when box 2016 is positioned at the second position, according to illustrated embodiment, at least one second activates strand 38b(and is interpreted as that the second anchor log 22b can comprise that more than one second activates strand 38b, for example can comprise the identical opening that passes the second anchor log main body 28b as required or pass two second that different openings weaves activating strand 38b) extend through the slit 2098 that grasps assembly 2021 and 2114 and breech lock 2092 and clip 2103 respectively.Should be appreciated that before box 2016 is moved to its second position, can manually discharge at least one from box 2016 and comprise that first of actuation part 131a and attachment part 131b activates strand 38a.

Referring now to Figure 55 C,, in case box 2016 is positioned at the second position, then pusher member 2022 can distad move to distal position from proximal position, thus internals 2008 and external member 2010 adjacency.When pusher member 2022 distad during translation, the far-end 2026b of intubate 2026 advances along intubate 2011, enters the second container 2060b and drive the second anchor log main body 28b to pass intubate 2012 and leave far-end 2014 and enter among the second opening 23b.As mentioned above, when pusher member 2022 was positioned at distal position, the far-end 2026b of intubate 2026 may extend into the position that flushes or be positioned at its distally with the far-end 2014 of intubate 2012 at least basically, was ejected intubate 2012 to guarantee the second anchor log main body 28b.Should be appreciated that the second actuating strand 38b keeps extending through the slit 2098 and 2114 that grasps assembly 2021.

Therefore, referring now to Figure 55 D,, and as above in conjunction with as described in Figure 51 A-51I, can be with tension force assembly 2020 from first or break away from configuration and be actuated to second or engagement configuration and be actuated to the 3rd or the tensioning configuration, under first configuration, at least one second activates strand 38b and can grasp for example slip in slit 2098 and 2114 of assembly 2021, under second configuration, grasp assembly 2021 and be attached at least one second actuating strand 38b that can comprise actuation part 131b and attachment part 133b, under the 3rd configuration, grasp assembly 2021 and in the above described manner the stretching actuation force is applied at least one second actuating strand 38b, thereby the second anchor log main body 28b is actuated to its expanded configuration from its first configuration.For example, can with lever 2082 from first or the middle position be pressed into second actuated position, this makes the motion assembly will grasp assembly 2021 proximad translations, thereby activate grasp assembly with in first composition surface 2100 and second composition surface 2115 at least one with respect to another composition surface motion, thereby reduce variable-sized gap 2116.According to illustrated embodiment, first composition surface 2100 can activate strand 38b to reduce variable-sized gap 2116 and to catch at least one second towards 2115 motions of second composition surface.Further actuating movement assembly 2023 makes and grasps assembly 2021 preset distance of advancing, and the stretching actuation force is applied at least one actuating strand 38b that catches.Referring to Figure 55 E, in case the second anchor log main body 28b expand, lever 2082 just for example at spring member 2118(referring to Figure 51 A-51I) power under turn back to its middle position, as mentioned above.Shown in Figure 53 E, for example by proximal force being applied to outer body 2010 intubate 2012 is removed from the second opening 23b, will insert apparatus 2000 and remove from the second target location 24b.

In case in corresponding target location 24a and the insertion of 24b place and expansion, the first actuation part 131a and the second actuation part 131b and the first attachment part 133a and the second attachment part 133b just can remove from jar 2072 for the first anchor log main body 28a and the second anchor log main body 28b.The first attachment part 133a and the second attachment part 133b can adopt any required mode to be attached to one another.Attachment part is being locked together (or locking onto on as shown in figure 33 other members) to keep before gap 24c engages, engaging force can be applied to activating strand 38a and 38b to reduce gap 24c.For example, Figure 52-55 shows engaged gap 24c in the bone (for example, fracture); Yet, can use similar method, sew up strand thus and in being driven into bone, pass soft tissue at first to stride tendon before the gap between joining tissue and the bone.According to alternative embodiment, be to be understood that, insert apparatus 2000 and can be configured to the first anchor log main body 28a and the second anchor log main body 28b are implanted among corresponding opening 23a and the 23b, for example be attached to simultaneously and grasp assembly 2021 and actuating movement assembly 2023 and anchor log main body 28a and 28b are actuated to its expanded configuration individually or side by side by activating strand 38a and 38b with two subsequently.

Participate in Figure 56 A-B now, should be appreciated that and to construct anchor log 22 as required according to any suitable embodiment.For example, anchor log 22 can comprise the anchor log main body 28 of constructing in conjunction with Figure 57 A-60D as hereinafter.For example, anchor log main body 28 restriction expandable parts 36 and connector members 63(are for example, the eyelet 90 that at least one extends from expandable part 36) and actuation member 37(referring to Figure 1A) such as activating strand 38, described actuation member is configured to expandable part 36 and anchor log main body 28 are actuated to expanded configuration shown in Figure 56 B from first configuration shown in Figure 56 A, under first configuration, anchor log main body 28 can be inserted into the target location at first, and (it can be bone for example as mentioned above, soft tissue or supplementary structure) in, under expanded configuration, anchor log main body 28 can be fixed to aforesaid target location.According to illustrated embodiment, activate strand 38 and can be configured to auxiliary strand 33, this auxiliary strand separates with anchor log main body 28 and is attached on the anchor log main body 28.Activate strand 38 and can limit actuation part 131 and attachment part 133.In conjunction with explanation hereinafter, should be appreciated that activating strand 38 can further be attached to the second anchor log main body, activate strand in order to limit in the above described manner the integral body that first anchor log and second anchor log are attached at together.Activate strand 38, for example actuation part 131 and attachment part 133 are configured to receive the stretching actuation force F that makes anchor log main body 28 be actuated to expanded configuration from first configuration.

Continuation is referring to Figure 56 A-B, and anchor log main body 28 and expandable part 36 all are elongated along central axis 29, and limits first or near-end 30 and second or far-end 32, this second or far-end spaced apart along central axis 29 and near-end 30 basically.Central axis 29 can limit Any shape or have the part of required Any shape.For example, the part of central axis 29 or central axis 29 can be linear, substantially linear, nonlinear, comprise rule, irregular or crooked, or can be shaped as required.According to illustrated embodiment, central axis 29 is substantially linear.Therefore, anchor log main body 28 can limit prolonging direction 34, and this prolonging direction extends on substantial linear ground between first terminal 30 and second end 32.For example should be appreciated that prolonging direction 34 can be consistent with central axis 29 basically when central shaft line 29 during for substantially linear.For example it is also understood that when central shaft line 29 when nonlinear, prolonging direction 34 at least in part or basically fully and central axis 29 separate.Expandable part 36 has first or near-end 39a and second or far-end 39b.The near-end 39a of expandable part 36 can consistent with the near-end 30 of anchor log main body 28 or different (for example, with respect to its depression), and the far-end 39b of expandable part 36 can with the far-end 32 consistent or different (for example, with respect to its depressions) of anchor log main body 28.

The expandable part 36 of anchor log main body 28 extends along prolonging direction 34, makes to limit initial distance D1 along prolonging direction 34 when expandable part 36 is in first configuration.Initial distance D1 can be any length as required, this length is in a scope, this scope has can be by about 5mm or approximately 10mm or approximately 20mm or the approximately lower end that limits of 24.5mm, and can be by about 50mm or approximately 40mm or the approximately upper end that limits of 30mm or about 25.5mm.

In addition, when being in first configuration, expandable part 36 defines the initial maximum thickness T1 that extends in second direction 35, and second direction 35 is with respect to prolonging direction 34 perpendicular.Can set the size of initial maximum thickness T1 as required.As shown in Figure 1B, when expandable part 36 was in expanded configuration, expandable part 36 shrank (for example compression or entanglement) to the second distance D2 that measures to far-end 39b along prolonging direction 34 from near-end 39a along prolonging direction 34.Second distance D2 can be less than initial distance D1.When expandable part 36 shrank along prolonging direction, for example when expandable part 36 is actuated to expanded configuration from first configuration, expandable part 36 was expanded to the second maximum ga(u)ge T2 greater than initial maximum thickness T1 along second direction 35.The second maximum ga(u)ge T2 extends along the second direction 35 that is substantially perpendicular to prolonging direction 34.

Maximum ga(u)ge T1 and T2 on the second direction 35 can be defined, and make anchor log main body 28 not be limited on the second direction 35 respectively the thickness greater than maximum ga(u)ge T1 and T2.For example should be appreciated that when being in expanded configuration because the configuration of expandable part 36 causes when expandable part 36 is actuated to expanded configuration, near-end 39a and far-end 39b can change the position on expandable part 36.Yet, when expandable part 36 is in expanded configuration, near-end 39a and far-end 39b continue to limit most proximal end and the distal-most end of expandable part 36, make when expandable part 36 is in expanded configuration, be limited to as the crow flies between the near-end 39a and far-end 39b of expandable part 36 along the distance B 2 of prolonging direction 34.

Expandable part 36 can limit a plurality of substantially concentric rings 31, described ring can be limited by a plurality of knots 49 that limit the first knot 49a and the second knot 49b integrally with each other and at least in part, described first knot and second is tied along central axis 29 and along the length of expandable part 36 and alternately is arranged, at least one that makes that the adjacent first knot 49a and the second knot 49b limit knot 49 be to 51, and at least one of described knot 49 is to 51 one in stop collars 31 at least in part then.For example a plurality of to 51 to 51(, mostly be all to 51 most) at least one each knot 49a and 49b with respect to another knot 49a and 49b biasing.For example, each can be arranged on the opposite side of central axis 29 51 knot 49a and 49b.According to an embodiment, each relative to each other arranges basically to 51 knot 49a and 49b, but is arranged on each between 51 the knot 49a and 49b with making central axis 29 substantial linear.For example, be to be understood that knot 49a and 49b that each is right can be offset as required angledly, for example relative to each other skew between about 90 degree and about 270 degree (comprising about 90 degree and about 270) comprises relative to each other skew between about 135 degree and 225 degree (comprising about 135 degree and 225 degree).According to an embodiment, each can be set to be oriented relative to one another to about 180 degree skews to 51 knot 49a and 49b.

Ring 31 can limit can be configured to central opening respective openings 40(for example, at least two openings 40), make central axis 29 extend along opening 40.Therefore, ring 31 and corresponding opening 40 can be in alignment with each other along prolonging direction 34.Therefore, when anchor log main body 28 was actuated to its expanded configuration, ring 31 was towards advancing each other and against piling up each other.Ring 31 can limit distally ring 31a, proximal ring 31b and at least one and be arranged on adapter ring 31c between proximal ring 31a and the distally ring 31b.Actuating strand 38 is configured to extend through at least one in the opening 40, comprises a plurality of openings 40, and for example at least two openings 40 mostly are whole openings 40 most.Therefore, when along prolonging direction 34 actuation force F being applied to actuating strand 38 basically, activate strand 38 can with expandable part 36 and and then 28 biasings of anchor log main body, shrinking along prolonging direction 34 and to expand along second direction 35, thereby make anchor log extend to expanded configuration from first configuration.Power F can be tension force, comprises that pure tension force maybe can be from the skew of pure tension force but have power as the component of pure tension force.Therefore it should be understood that and power F can be applied to corresponding actuating strand 38 along prolonging direction 34 basically, make capable F can have with prolonging direction 34 parallel or consistent or can with the parallel or consistent fully vectors of prolonging direction 34.

Continuation is referring to Figure 56 A-B, and anchor log main body 22 can be the form of base material 42, and it can be strand in one embodiment, for example sews up strand or any strand of structure alternatively, and this base material defines anchor log main body strand 44.Anchor log main body strand 44 can be absorbable together with the miscellaneous part of anchor log assembly 20 as required.Anchor log main body strand 44 can have required any suitable USP(American Pharmacopeia) size (or diameter), for example between USP7-0 and USP5, (comprise USP7-0 and USP5), such as between USP2-0 and USP5, (comprising USP2-0 and USP5), USP2 for example.Anchor log main body strand 44 can be woven and porous, in order to limit opening, or can be as required for non-woven and lack opening.No matter anchor log main body strand 44 is woven or non-woven, all can weave anchor log main body strand 44 as required in order to limit opening 40, as describing in more detail in conjunction with Figure 57 A-60D hereinafter.Activate strand 38 and can have required any suitable USP(American Pharmacopeia) size (or diameter), for example, between USP7-0 and USP5, (comprise USP7-0 and USP5), such as between USP2-0 and USP5, (comprising USP2-0 and USP5).

The method of the structure anchor log 22 shown in Figure 56 A-B will be described now.For example, referring to Figure 57 A, anchor log main body strand 44 limits at least one eyelet 90 and make position 113, and this make position can limit the base portion of eyelet 90.Can be as required construct eyelet 90 according to the embodiment of any amount.For example, shown in Figure 57 B-C, can construct eyelet 90 by folding anchor log main body strand 44, limiting the first section 92a and the second section 92b, described first section and second section by molding so that stop collar 91.Ring 91 can be by the first section 92a and the second section 92b around limiting opening, and encircle 91 and can pass through the opening feeding, ties to limit at make position 113 places.

Alternatively, referring to Figure 57 D, can be with second section 92b welding (for example heating or via binding agent) to the first section 92a, in order to will encircle 91 closures and limit the make position 113 of eyelet 90.Alternatively, referring to Figure 57 E, the second section 92b of terminal can be sewn onto the first section 92a at make position 113 places, in order to will encircle 90 closed and limit the base portion of eyelet 90.For example, can with strand for example at least one sew up that strand 75 passes the first section 92a and the second section 92b sews up so that the first section 92a and the second section 92b are engaged with each other.

Alternatively, referring to Figure 57 F-L, anchor log main body strand 44 can be woven into self in order to limit eyelet 90.According to an embodiment, totally referring to Figure 57 F-G, anchor log main body strand 44 can be passed self and fold and sew up, with stop collar 91 respectively and from encircling the first section 92a and the second section 92b that 91 opposite side extends.The tip of pin 94 can be passed the first section 92a and insert, in order to limit the first passage that extends through the first section 92a.Can the second section 92b be passed through the eyelet feeding of pin 94 at the tail end of pin 94.Then, pin 94 can translate across the first section 92a forward, makes the second section 92b be pulled through the passage that is formed by pin 94 among the first section 92a, thereby makes ring 91 closures and limit first needle tracking 93 shown in Figure 57 G.Ring 91 distad extends from first needle tracking 93.Shown in Figure 57 H, the second section 92b can translate across the first section 92a in an opposite direction with the size of adjustable ring 91 as required.According to an embodiment, when tension, ring 91 can be adjusted to the length of about 5mm.

Then, referring to Figure 57 I-J, anchor log main body strand 44 can be passed self secondary suture.For example, distal position at first needle tracking 93, but section 92a and the 92b of anchor log main body strand 44 are passed in the tip of driving needle 94, thereby form second channel and the third channel that extends through the first section 92a and the second section 92b respectively in the distal position of first needle tracking 93.Shown in Figure 57 J, the second section 92b can be passed the eyelet feeding of pin 94, pin 94 can translate across second channel and third channel forward then, make the second section 92b be pulled through self in a side of ring 91, and the opposite side at ring 91 is passed the first section 92a by further pulling, limits second needle tracking 95 with the distal position at first needle tracking 93.But the base portion of first needle tracking 93 and second needle tracking, 95 stop collars 91.The second section 92b also limits from the ring 96 of first needle tracking 93 and 95 extensions of second needle tracking.Should be appreciated that after forming second needle tracking 95 therefore the size of ring 91 for example can reduce approximately 1mm.

Referring to Figure 57 K-L, anchor log main body strand 44 can be tied up at first needle tracking 93 and second needle tracking, 95 places and be tied in a knot 97 with the fixing size that limits the ring 91 of eyelet 90.For example, the second section 92b can limit free end 92c, and this free end extends through ring 96 from the third channel of the second section 92b, is tightened up to limit knot 97 subsequently.Therefore, knot 97 is arranged on the base portion of ring.Should be appreciated that form knot 97 with retainer ring 91 before, can repeatedly the second section 92b be passed ring 91 as required and sew up.Therefore it should be understood that can by anchor log main body strand 44 is passed self sew up to form at least one needle tracking (for example two needle trackings) thus form eyelet 90 stop collars, break into knot 97 with fixing eyelet 90 around base portion subsequently.

A method of structure expandable part 36 comprises that braiding activates strand 44, as describing in conjunction with Figure 58 A-F now.For example, shown in Figure 58 A-B, anchor log main body strand 44 is placed against mandrel 79, makes win section 92a and the second section 92b extend the base portion of eyelet 90.The first section 92a can be become any suitable knot 49 that can limit the first knot 49a with the second section 92b tying-up.Can any required mode break at least the first knot 49a(and mostly be all knots 49 most), alternative knot of reef knot as shown in the figure, anticreep knot (referring to Figure 59) or any appropriate structuring for example.The first knot 49a is located so that mandrel 79 is set up or is trapped between the base portion and the first knot 49a of eyelet 90.Can by the first section 92a and the second section 92b base portion and first of eyelet 90 be tied 49a respectively engages.

Referring now to Figure 58 C-D,, the first section 92a and the second section 92b tying-up each other tie 49b to limit second, described second knot can arrange to limit first couple of 51a of knot 49a and 49b basically with respect to the first knot 49a, described first pair can engage so that first or distally of stop collar 31 ring 31 around mandrel 79 by the first section 92a and second section 92.The first ring 31a defines corresponding first central opening 40 that is occupied by mandrel 79.The shape of the opening 40 of mandrel 79 and ring 31 can be substantial cylindrical or any suitable alternative shape as required.Though knot 49a becomes 180 degree to arrange with 49b as shown in the figure toward each other basically, should be appreciated that knot 49a and 49b can or center on the periphery skew of mandrel 79 as required.In addition, comprise a pair of 51 knots 49 though encircle 31, should be appreciated that a plurality of knots that each ring 31 can comprise requirement, for example at least one or a plurality of (comprising a pair of) knot 49.Therefore, we can say that ring 31 comprises one group (for example a pair of 51) knot 49, it can comprise the first knot 49a and the second knot 49b, and this first knot and second knot are by the first section 92a and the second section 92b joint of anchor log main body strand 44.

Shown in Figure 58 E-F, the first section 92a can be in the same place with the second section 92b tying-up, to tie the first knot 49a of second couple of 51b of relative position restriction knot basically of 49b at second of first couple of for example contiguous 51a, and the first section 92a can be in the same place with the further tying-up of the second section 92b, relative position limit second couple the second knot 49b basically with the first knot 49a at for example second couple of 51b.Therefore, the first knot 49a of second couple of 51b and the second knot 49b are engaged by first section and second section, in order to limit the ring of second in a plurality of rings 31.According to illustrated embodiment, second ring arranges along the central axis 23 contiguous first ring 31a.Second ring can be spaced apart with the first ring 31a, or can encircle 31a adjacency basically with first as required.But the tying-up first strand 92a and the second strand 92b subsequently, with limit as required first the knot 49a and second the knot 49b any suitable quantity to 51, thereby limit a plurality of corresponding ring 31 of requirement, described ring is separated from one another along the direction that is arranged essentially parallel to central axis 23.According to an embodiment, anchor log main body 28, for example the expandable part 36 of anchor log main body 28 can limit the first knot 49a and second knot five of 49b to 51.Yet, be to be understood that, can be as required with 44 braidings of anchor log main body strand repeatedly, make anchor log main body 28 especially expandable part 36 limit the first knot 49a and the second knot 49b at least two pairs 51, at least one pair of ring 31 of described at least two pairs of at least part of restrictions, then limit along a pair of corresponding opening 40 of central axis 23 alignment, make the central axis 23 extensible openings 40 that pass.Shown in Figure 58 G, the unnecessary length of the first section 92a and the second section 92b can be trimmed to the position of contiguous terminal ring, alternatively or in addition and sintering or fusing each other, or, be melted to contiguous ring 31 to limit the near-end 30 of anchor log main body 28.

Then, referring to Figure 58 H, can pass eyelet 90 feedings with activating strand 38, make that activating strand 38 extends through eyelet 90 slidably to limit from the extended first section 59a of the basic opposite side of eyelet 90 and the second section 59b.The first section 59a can limit the relative corresponding free end that activates strand 38 with the second section 59b, and the eyelet that this free end can be passed the mandrel 79 that can be configured to pin comes feeding.Then, mandrel 79 can be passed the pulling of opening 40 proximads along central axis 23 the first section 59a and the second section 59b are passed the pulling of opening 40 proximads basically along central axis 23.Therefore, the first section 59a and the second section 59b can limit actuation part 131 and the attachment part 133 of anchor log 22 respectively.

Should be appreciated that the ring 31 that can engage nearside passes expandable part 36 to provide support to spur to activate strand 38, this is pressed against each other ring 31.Therefore, drive eyelet 90 but activate strand 38 proximads, make eyelet extend from the first ring 31a proximad along central axis 23 basically.According to the quantity of the ring 31 of the length of for example eyelet 90 and expandable part, eyelet 90 extensible at least one opening 40 that pass, for example, a plurality of openings 40 mostly are whole openings 40 most, so that proximad extends the near-end 39a of expandable part 36.Therefore, passed after expandable part is pulled activating strand 38, anchor log 22 is in expanded configuration.Therefore, refer again to Figure 56 A, expandable part 36 can extend to its first configuration along activating strand 38, and eyelet 90 can be embedded in the expandable part 36 thus.

Should be appreciated that eyelet 90 base portion can with the first ring 31a adjacency.Therefore, when actuation force F is applied to when activating strand 38, the base portion of eyelet 90 and first or distally ring 31a between machinery disturb the base portion that prevents eyelet 90 to pass expandable part 36 proximads to advance.Therefore, when anchor log main body 28 is actuated to expanded configuration, ring 31 piles up and is pressed against each other along the direction that is arranged essentially parallel to central axis 23, and this makes ring 31 expanded radiallys, thereby makes expandable part 36 and anchor log main body 28 be expanded to the second maximum ga(u)ge T2 along second direction 35.In addition, the eyelet 90 extensible expandable parts 36 that pass, when eyelet 90 was added into expandable part 36 along prolonging direction 34 with structural rigidity, this expandable part can make opening 40 expanded radiallys.

Be to be understood that, when ring 31 is pressed against each other during expandable part 36 is actuated to expanded configuration from first configuration, the length of expandable part 36 reduces, and can be reduced to the length less than eyelet 90, make that eyelet 90 can be extended out the near-end 39a of expandable part 36 when anchor log main body 28 has been driven to expanded configuration.Therefore, when anchor log main body 28 expanded, actuating strand 38 can pass eyelet 90 and freely slide.Therefore, we can say when expandable part 36 is in first configuration, eyelet 90 along first length of expandable part 36 (for example, the ring 31 of first quantity) proximad extends in the expandable part 36 at least, and when expandable part 36 is in expanded configuration, eyelet along second length of expandable part (for example, the ring 31 of second quantity) proximad extends in the expandable part 36 and (for example passes wherein) at least, wherein second length is greater than first length (for example, the ring 31 of second quantity is greater than the ring 31 of first quantity).For example should be appreciated that when expandable part is in first configuration if eyelet distad extends from the far-end 39b of expandable part 36, then first length can equal zero.

As mentioned above, anchor log main body 28 can comprise at least one eyelet 90.For example, referring to Figure 60 A-D, anchor log main body 28 can limit a pair of eyelet 90a and the 90b that extends from expandable part 36.For example, shown in Figure 60 C, can with anchor log main body strand 44 folding twice limiting the first ring 91a and the second ring 91b, described first ring and second encircles with side by side relationship setting and limits roughly " W shape ".Therefore, actuating strand 44 can limit respectively and encircle the extended first section 92a of 91b and the second section 92b from the first ring 91a and second, and the jointing 92d of extension between first ring and second ring.First section and second section can be attached to jointing 92d to be defined for the shared base portion of the first ring 91a and the second ring 91b, and described first ring and second ring can be closed in any of the above methods, to limit the corresponding first eyelet 90a and the second eyelet 90b.For example, can with the first section 92a and the second section 92b and jointing 92d each other tying-up to limit shared base portion.The first section 92a and the second section 92b can extend to limit expandable part 36 from sharing base portion, as mentioned above.The eyelet 90 that should be appreciated that type described herein can be in aggregates with anchor log main body strand 44 as described herein, or can separate with anchor log main body strand 44, and adopt any suitable manner and anchor log main body strand 44 attached as required.

The embodiment that describes in conjunction with illustrated embodiment provides in illustrational mode, so the present invention is intended to be subject to the disclosed embodiments.In addition, except as otherwise noted, otherwise multiple structure, feature and the method relevant with any embodiment as herein described can be applicable to any other embodiment as described herein.For example, except as otherwise noted, otherwise according to any suitable alternative embodiment, any insertion apparatus as herein described can comprise tension force assembly as described herein.For example, any insertion apparatus as herein described can comprise the fusion element of suitable above-mentioned any kind, predetermined travel distance or their suitable combinations of suitable above-mentioned any kind.Therefore, those skilled in the art will appreciate that, the present invention is intended to contain within the spirit and scope of the present invention all correction forms and the alternative layouts mode of comprising as described in the appended claims.

Claims (125)

1. one kind is configured at the insertion apparatus of target location with at least one anchor log ejection, described anchor log comprises the anchor log main body of extending along prolonging direction basically, described anchor log comprises also that basically along the actuation member of described prolonging direction from described anchor log Subject Extension, described insertion apparatus comprises:

Longitudinally be the elongated member that enters, describedly enter the far-end that component limit is configured to insert at least in part described target location;

Can carry the anchor log shell of described at least one anchor log, described anchor log shell is configured to align with the described member that enters with discharging; And

Pusher member, described pusher member are configured to insert described anchor log shell, and described at least one anchor log is ejected and goes out from the described far-end that enters member from described anchor log shell.

2. insertion apparatus according to claim 1, wherein said component limit first intubate that enters, described first intubate extends longitudinally passes the described member that enters, and its size is configured at least a portion of described anchor log shell is contained in wherein, and wherein said anchor log shell limits second intubate, described second intubate extends longitudinally passes described anchor log shell, and its size is configured at least a portion of described pusher member is contained in wherein.

3. insertion apparatus according to claim 2, wherein said pusher member limits the 3rd intubate, and described the 3rd intubate extends longitudinally passes described pusher member, and its size is configured at least a portion of described actuation member is contained in wherein.

4. insertion apparatus according to claim 3 has wherein saidly entered component limit at the described contact surface that enters the proximal end of member, and described contact surface is configured to second contact surface that limits in abutting connection with by described anchor log shell.

5. in the middle of insertion apparatus according to claim 4, wherein said second contact surface are positioned at respect to the relative near-end of described anchor log shell and far-end.

6. insertion apparatus according to claim 5, wherein when described anchor log shell with respect to described when entering member and inserting fully, described second contact surface is in abutting connection with described contact surface.

7. insertion apparatus according to claim 6, wherein when described anchor log shell with respect to described when entering member and inserting fully, the far-end of described anchor log shell and the described far-end substantial alignment that enters member.

8. insertion apparatus according to claim 6, wherein said anchor log shell defines the 3rd contact surface in the proximal end of described anchor log shell, and described the 3rd contact surface is configured to the 4th contact surface that limits in abutting connection with by described pusher member.

9. in the middle of insertion apparatus according to claim 8, wherein said the 4th contact surface are positioned at respect to the relative near-end of described pusher member and far-end.

10. insertion apparatus according to claim 9, wherein when described pusher member is inserted fully with respect to described anchor log shell, the far-end of described pusher member and the described far-end substantial alignment that enters member.

11. insertion apparatus according to claim 10, the wherein said near-end that enters member limits first interlocking component, and described anchor log shell limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member, described anchor log shell and the relative to each other translation longitudinally of described pusher member.

12. insertion apparatus according to claim 9, wherein when described pusher member is inserted fully with respect to described anchor log shell, the far-end of described pusher member and the described respective distal end substantial alignment that enters member and described anchor log shell.

13. insertion apparatus according to claim 12, the wherein said near-end that enters member limits first interlocking component, and described anchor log shell limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member and the relative to each other translation longitudinally of described anchor log shell.

14. insertion apparatus according to claim 13, the near-end of wherein said anchor log shell limits the 3rd interlocking component, and described pusher member limits and is configured to the tetrad lock construction element that engages with described the 3rd interlocking component, wherein when described the 3rd interlocking component and tetrad lock construction element joint, prevent the relative to each other translation longitudinally of described anchor log shell and described pusher member.

15. insertion apparatus according to claim 9, wherein when described second contact surface and described contact surface are adjacent to each other, and when described the 4th contact surface and described the 3rd contact surface were adjacent to each other, described anchor log was ejected the far-end of described anchor log shell.

16. insertion apparatus according to claim 9 also comprises the opening formation member that is configured to insert described first intubate, described opening forms component limit:

Tip, described tip are positioned at the far-end that described opening forms member;

The 5th contact surface, described the 5th contact surface be configured to when described opening form member with respect to described when entering member and inserting fully in abutting connection with described contact surface; And

Axle, described axle extends between described tip and described the 5th contact surface.

17. insertion apparatus according to claim 16, wherein said tip are coniform shape.

18. insertion apparatus according to claim 16, at least one bore hole groove of wherein said axis limit, described bore hole groove is along extending from described most advanced and sophisticated spirality ground towards the direction of described the 5th contact surface.

19. insertion apparatus according to claim 16, the wherein said near-end that enters member limits first interlocking component, and described opening forms component limit and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member and the relative to each other translation longitudinally of described opening formation member.

20. insertion apparatus according to claim 3, the diameter of wherein said the 3rd intubate is shorter than the cross sectional dimensions of described anchor log, make that the far-end of described pusher member makes the translation longitudinally of described anchor log when described pusher member is inserted described anchor log shell.

21. insertion apparatus according to claim 20, wherein when described pusher member was inserted fully with respect to described anchor log shell, described pusher member sprang in the described opening described anchor log.

22. insertion apparatus according to claim 1, also comprise the tension force assembly, described tension force assembly is configured to predetermined tension characteristic is applied to described actuation member, thereby described anchor log main body is expanded along second direction, and described second direction is offset with respect to described prolonging direction angledly.

23. insertion apparatus according to claim 22, wherein said tension force assembly comprises translation member, and described translation member is configured to move to extended position with respect to the described far-end that enters member from the middle position.

24. insertion apparatus according to claim 23, wherein when described translation member was positioned at described primary importance, described translation member was in abutting connection with the near-end of described pusher member.

25. insertion apparatus according to claim 23, wherein when described translation member between described middle position and described extended position during translation, described translation member is applied to described actuation member with tension force.

26. insertion apparatus according to claim 25 also comprises rotating parts, described rotating parts makes described translation member move to described extended position from described middle position.

27. insertion apparatus according to claim 26, wherein said translation member limits at least one protuberance, and described at least one protuberance extends from described translation member along the third direction that is substantially perpendicular to described prolonging direction.

28. insertion apparatus according to claim 27, wherein said pusher member limit at least one second protuberance, described at least one second protuberance extends from described pusher member along described third direction.

29. insertion apparatus according to claim 28, wherein said rotating parts comprises main body, described main part limitation is configured to hold the hole of described at least one protuberance, and described main part limitation is configured to hold the slit of described at least one second protuberance, and described slit has nearside slit end and relative distally slit end.

30. insertion apparatus according to claim 29, wherein said slit extend between described nearside slit end and distally slit end linearly.

31. insertion apparatus according to claim 29, wherein said rotating parts makes described at least one second protuberance translation in described slit around the rotation of the axis that is substantially perpendicular to described prolonging direction.

32. insertion apparatus according to claim 31, wherein said axis is limited by described at least one protuberance.

33. insertion apparatus according to claim 29, wherein when described at least one second protuberance was arranged on described nearside slit end, described translation member was positioned at described primary importance.

34. insertion apparatus according to claim 33, wherein when described at least one second protuberance was arranged on slit end, described distally, described translation member was positioned at the described second position.

35. insertion apparatus according to claim 33 wherein revolves described rotating parts to turn 90 degrees and makes described at least one second protuberance move to described distally slit end from described nearside slit end.

36. insertion apparatus according to claim 35, wherein said rotating parts main body comprises plate.

37. insertion apparatus according to claim 34, the wherein said near-end that enters member limits first interlocking component, and described anchor log shell limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component engage, prevent that described member and the described anchor log shell of entering is relative to each other around rotation.

38. according to the described insertion apparatus of claim 37, the near-end of wherein said anchor log shell limits the 3rd interlocking component, and described pusher member limits and is configured to the tetrad lock construction element that engages with described the 3rd interlocking component, wherein when described the 3rd interlocking component and tetrad lock construction element joint, prevent the relative to each other translation longitudinally of described anchor log shell and described pusher member.

39. insertion apparatus according to claim 34, the wherein said near-end that enters member limits first interlocking component, and described pusher member limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member, described anchor log shell and the relative to each other translation longitudinally of described pusher member.

40. insertion apparatus according to claim 34 also comprises the opening formation member that is configured to insert described first intubate, described opening forms component limit:

Tip, described tip are positioned at the far-end that described opening forms member;

The 5th contact surface, described the 5th contact surface be configured to when described opening form member with respect to described when entering member and inserting fully in abutting connection with described contact surface; And

Axle, described axle extends between described tip and described the 5th contact surface.

41. according to the described insertion apparatus of claim 40, wherein said tip is coniform shape.

42. according to the described insertion apparatus of claim 40, at least one bore hole groove of wherein said axis limit, described bore hole groove is along extending from described most advanced and sophisticated spirality ground towards the direction of described the 5th contact surface.

43. according to the described insertion apparatus of claim 40, the wherein said near-end that enters member limits first interlocking component, and described opening forms component limit and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member and the relative to each other translation longitudinally of described opening formation member.

44. insertion apparatus according to claim 28, wherein said rotating parts makes described translation member with respect to described pusher member translation around being arranged essentially parallel to the rotation of longitudinal axis longitudinally.

45. according to the described insertion apparatus of claim 44, wherein said rotating parts comprises main body, described main body longitudinally limits the bore hole that passes wherein, described bore hole limits inner surface, and the size of described bore hole is configured at least a portion of described pusher member and described translation member are contained in wherein.

46. according to the described insertion apparatus of claim 45, wherein said at least one protuberance comprises first pair of protuberance, and described at least one second protuberance comprises second pair of protuberance.

47. according to the described insertion apparatus of claim 46, wherein said first pair of protuberance extends along first common axis, described second pair of protuberance extends along second common axis, and described first common axis is relative to each other parallel with second common axis.

48. according to the described insertion apparatus of claim 46, wherein said bore hole also limits ring-shaped groove and a pair of relative helicla flute, described ring-shaped groove and described helicla flute extend in the described inner surface, each helicla flute extends between corresponding relative nearside groove end and distally groove end, each protuberance of described second pair of protuberance is trapped in the described a pair of spiral fluted corresponding, and described first pair of protuberance is trapped in the described ring-shaped groove, make when described rotating parts rotates around described longitudinal axis, described translation member is free shift in described rotating parts, and described pusher member rotates freely in described rotating parts.

49. according to the described insertion apparatus of claim 48, wherein each helicla flute limits corresponding variable groove slot pitch.

50. according to the described insertion apparatus of claim 49, wherein the corresponding groove slot pitch of each spiral fluted becomes more shallow between corresponding far-end and near-end.

51. according to the described insertion apparatus of claim 48, wherein said pusher member also limits at least one axle, described axle longitudinally extends from described pusher member proximad, described translation member is configured to carry along described at least one quilt, makes to prevent that described translation member from rotating with respect to described rotating parts.

52. according to the described insertion apparatus of claim 51, wherein when described second pair of protuberance was arranged on groove end, corresponding distally, described translation member was positioned at described primary importance.

53. according to the described insertion apparatus of claim 52, wherein when described second pair of protuberance was arranged on corresponding nearside groove end, described translation member was positioned at the described second position.

54. according to the described insertion apparatus of claim 44, the wherein said near-end that enters member limits first interlocking component, and described anchor log shell limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component engage, prevent that described member and the described anchor log shell of entering is relative to each other around described longitudinal axis rotation.

55. according to the described insertion apparatus of claim 54, wherein when described first interlocking component and second interlocking component joint, further prevent described enter member and the relative to each other translation longitudinally of described anchor log shell.

56. according to the described insertion apparatus of claim 55, the near-end of wherein said anchor log shell limits the 3rd interlocking component, and described pusher member limits and is configured to the tetrad lock construction element that engages with described the 3rd interlocking component, wherein when described the 3rd interlocking component and tetrad lock construction element joint, prevent that described anchor log shell and described pusher member are relative to each other around described longitudinal axis rotation.

57. according to the described insertion apparatus of claim 56, wherein when described the 3rd interlocking component and tetrad lock construction element joint, further prevent the relative to each other translation longitudinally of described anchor log shell and described pusher member.

58. according to the described insertion apparatus of claim 57, the wherein said member that enters also limits the relative contact pin of a pair of side direction, described contact pin stretches out from the described member that enters along described third direction.

59. according to the described insertion apparatus of claim 54, the wherein said near-end that enters member limits first interlocking component, and described pusher member limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent that described member, described anchor log shell and the described pusher member of entering is relative to each other around described longitudinal axis rotation.

60. according to the described insertion apparatus of claim 59, wherein when described first interlocking component and second interlocking component joint, further prevent described enter member and the relative to each other translation longitudinally of described anchor log shell.

61. according to the described insertion apparatus of claim 60, the wherein said member that enters also limits the relative contact pin of a pair of side direction, described contact pin stretches out from the described member that enters along described third direction.

62. according to the described insertion apparatus of claim 51, also comprise the opening formation member that is configured to insert described first intubate, described opening forms component limit:

Tip, described tip are positioned at the far-end that described opening forms member;

The 5th contact surface, described the 5th contact surface be configured to when described opening form member with respect to described when entering member and inserting fully in abutting connection with described contact surface; And

Axle, described axle extends between described tip and described the 5th contact surface.

63. according to the described insertion apparatus of claim 62, wherein said tip is coniform shape.

64. according to the described insertion apparatus of claim 62, at least one bore hole groove of wherein said axis limit, described bore hole groove is along extending from described most advanced and sophisticated spirality ground towards the direction of described the 5th contact surface.

65. according to the described insertion apparatus of claim 62, the wherein said near-end that enters member limits first interlocking component, and described opening forms component limit and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member and the relative to each other translation longitudinally of described opening formation member.

66. insertion apparatus according to claim 6 also comprises:

Be attached to the translation member of the near-end of described pusher member, described translation member is configured to longitudinally with respect to the translation of described anchor log shell, and described actuation member can be attached to described translation member with discharging; And

Be configured to carry the handle member of described translation member, described handle member is supported by described anchor log shell, and can be with respect to the translation between primary importance and the second position of described anchor log shell.

67. according to the described insertion apparatus of claim 66, wherein when handle member was positioned at described primary importance, described at least one anchor log was arranged in the described anchor log shell.

68. according to the described insertion apparatus of claim 67, wherein when described handle member moved to the described second position from described primary importance, described anchor log was sprung in the described opening.

69. according to the described insertion apparatus of claim 66, wherein when handle member was positioned at described primary importance, described at least one anchor log was arranged on the far-end of described anchor log shell.

70. according to the described insertion apparatus of claim 66, wherein when described handle member was positioned at the described second position, described second contact surface was in abutting connection with described first contact surface.

71. according to the described insertion apparatus of claim 66, wherein when described handle member is positioned at the described second position, the far-end of described anchor log shell and the described far-end substantial alignment that enters member.

72. according to the described insertion apparatus of claim 66, wherein when described handle member is not positioned at the described second position, prevent that described handle member from centering on the central axis that is limited by described anchor log shell and rotating with respect to described anchor log shell.

73. according to the described insertion apparatus of claim 66, wherein when described handle member is positioned at the described second position, prevent that described handle member is with respect to the translation longitudinally of described anchor log shell.

74. according to the described insertion apparatus of claim 66, wherein when described handle member was positioned at the described second position, described handle member can be rotated with respect to described anchor log shell around the central axis that is limited by described anchor log shell.

75. according to the described insertion apparatus of claim 74, wherein said handle member makes described translation member with respect to the translation of described anchor log shell around the rotation of described central axis.

76. according to the described insertion apparatus of claim 75, the distally main component that wherein said translation member comprises the nearside main component and is configured to can engage with described nearside main component with discharging, described pusher member is attached to described distally main component.

77. according to the described insertion apparatus of claim 76, wherein when the rotation of described handle member, described translation member with respect to described anchor log shell from the translation of initial position proximad.

78. according to the described insertion apparatus of claim 77, wherein when described translation member was positioned at described initial position, described actuation member was trapped between described nearside main component and the distally main component.

79. according to the described insertion apparatus of claim 78, wherein said handle member limits the bore hole that longitudinally passes wherein, described bore hole limits inner surface, and the size of described bore hole is configured to hold described translation member.

80. according to the described insertion apparatus of claim 79, wherein said translation member limits a pair of protuberance, described protuberance extends from described nearside main component along the third direction that is substantially perpendicular to described central axis.

81. 0 described insertion apparatus according to Claim 8, wherein said protuberance extends along second axis with respect to described central axis perpendicular.

82. 0 described insertion apparatus according to Claim 8, wherein said bore hole also limits a pair of relative helicla flute that extends in the described inner surface, each helicla flute extends between corresponding relative nearside groove end and distally groove end, each protuberance of described a pair of protuberance is trapped in the described a pair of spiral fluted corresponding, make that described translation member is with respect to described anchor log shell free shift when described handle member is rotated around described central axis.

83. 2 described insertion apparatuses according to Claim 8, wherein said anchor log shell also limits at least one axle, described axle longitudinally extends from described anchor log shell proximad, described translation member is configured to carry along described at least one quilt, makes to prevent that described translation member from rotating with respect to described anchor log shell.

84. 2 described insertion apparatuses according to Claim 8 wherein are arranged on corresponding distally groove when terminal when described each protuberance, described translation member is positioned at described initial position.

85. 2 described insertion apparatuses according to Claim 8, wherein each helicla flute limits corresponding variable groove slot pitch.

86. 5 described insertion apparatuses according to Claim 8, wherein the corresponding groove slot pitch of each spiral fluted becomes more shallow between corresponding far-end and near-end.

87. according to the described insertion apparatus of claim 78, wherein said translation member makes tension force be applied to described actuation member with respect to the nearside translation of described anchor log shell.

88. 7 described insertion apparatuses according to Claim 8, wherein when release value that the size of described tension force equals to be scheduled to, described distally main component and described nearside main component break away from, thereby described actuation member is discharged from described translation member.

89. 8 described insertion apparatuses according to Claim 8, wherein said nearside main component limits at least one shear component, and described shear component is configured to engage with the complimentary engagement means that is limited by described distally main component.

90. 9 described insertion apparatuses according to Claim 8, wherein when described tension force equals described predetermined release value, described engagement member makes described shear component be sheared from described nearside main component, thereby described nearside main component and described distally main component are broken away from.

91. according to the described insertion apparatus of claim 75, the wherein said near-end that enters member limits first interlocking component, and described anchor log shell limits and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component engage, prevent that described member and the described anchor log shell of entering is relative to each other around described central axis rotation.

92. according to the described insertion apparatus of claim 91, wherein when described first interlocking component and second interlocking component joint, further prevent described enter member and the relative to each other translation longitudinally of described anchor log shell.

93. according to the described insertion apparatus of claim 92, the wherein said member that enters also limits the relative contact pin of a pair of side direction, described contact pin stretches out from the described member that enters along described third direction.

94. 3 described insertion apparatuses also comprise the opening formation member that is configured to insert described first intubate according to Claim 8, described opening forms component limit:

Tip, described tip are positioned at the far-end that described opening forms member;

The 5th contact surface, described the 5th contact surface be configured to when described opening form member with respect to described when entering member and inserting fully in abutting connection with described contact surface; And

Axle, described axle extends between described tip and described the 5th contact surface.

95. according to the described insertion apparatus of claim 94, wherein said tip is coniform shape.

96. according to the described insertion apparatus of claim 94, at least one bore hole groove of wherein said axis limit, described bore hole groove is along extending from described most advanced and sophisticated spirality ground towards the direction of described the 5th contact surface.

97. according to the described insertion apparatus of claim 94, the wherein said near-end that enters member limits first interlocking component, and described opening forms component limit and is configured to second interlocking component that engages with described first interlocking component, wherein when described first interlocking component and second interlocking component joint, prevent described enter member and the relative to each other translation longitudinally of described opening formation member.

98. insertion apparatus according to claim 22, the wherein said member that enters comprises the intubate with far-end, and described insertion apparatus comprises that also the opening that limits open pointed tip forms member, described open pointed tip can move to the second position with respect to described remote extension from the primary importance with respect to described far-end retraction, makes the described far-end that enters the described intubate of member limit described pusher member.

99. according to the described insertion apparatus of claim 98, wherein said target location is first target location, and described open pointed tip is configured to form first opening in described first target location.

100. according to the described insertion apparatus of claim 99, wherein said anchor log shell comprises box, described box limits first container and second container that keeps the first anchor log main body and the second anchor log main body respectively.

101. according to the described insertion apparatus of claim 100, also define pit, described pit is configured to hold described box slidably, makes described box can move to the second position that described second container aligns with described pusher member from the primary importance that described first container aligns with described pusher member.

102. according to the described insertion apparatus of claim 101, the backstop folder that wherein said box comprises the box shell that limits described first container and second container and is attached to described box shell removedly, wherein said backstop folder moves to the described second position in order to prevent described box from described primary importance in abutting connection with the described part of described insertion apparatus.

103. according to the described insertion apparatus of claim 102, wherein remove described backstop folder from described box shell and allow described box to move to the described second position from described primary importance.

104. according to the described insertion apparatus of claim 101, wherein said pusher member is configured to translate across described first container when described box is positioned at described primary importance, in order to the described first anchor log main body is ejected described intubate and enters described first opening.

105. according to the described insertion apparatus of claim 101, wherein said open pointed tip is configured to form second opening in second target location.

106. according to the described insertion apparatus of claim 105, wherein said pusher member is configured to translate across described first container when described box is positioned at the described second position, in order to the described second anchor log main body is ejected described intubate and enters described second opening.

107. insertion apparatus according to claim 22, wherein said tension force assembly can move to the second position that engages with described actuating strand from the primary importance with described actuation member disengaging, moves to make described tension force assembly tension force is applied to the 3rd position of described actuating strand again.

108. insertion apparatus according to claim 22, wherein said tension force assembly comprises and grasps assembly and motion assembly, the described assembly that grasps is configured to engage described actuating strand when described tension force assembly is positioned at the described second position, described motion assembly is configured to along the direction away from described anchor log main body the described assembly that grasps be moved, so that described predetermined tension characteristic is applied to described actuating strand.

109. according to the described insertion apparatus of claim 109, wherein said motion assembly makes and describedly grasps assembly motion preset distance in order to apply described predetermined tension characteristic.

110. according to the described insertion apparatus of claim 109, the wherein said assembly that grasps can be along sliding away from the shell of the described direction that enters member along described insertion apparatus.

111. according to the described insertion apparatus of claim 108, the wherein said assembly that grasps comprises first composition surface and second composition surface relative with described first composition surface, in wherein said first composition surface and second composition surface at least one can be with respect to another person's motion in described first composition surface and second composition surface, the variable-sized gap that is configured to keep described actuation member with restriction.

112. according to the described insertion apparatus of claim 108, wherein said motion assembly comprises actuator and can be attached to the breech lock of described actuator pivotally, and described motion assembly also comprises the gripping member of holding described breech lock at least in part, make the motion of described actuator that described breech lock is moved with respect to described gripping member, in order to catch described actuation member.

113. according to the described insertion apparatus of claim 112, wherein when described actuation member was trapped between described breech lock and the described gripping member, the described motion of described actuator made described breech lock and described gripping member enter member and translation away from described.

114. an inflatable grappling part that is configured to insert anatomical position, described inflatable grappling part comprises:

The anchor log main body, described anchor log main body comprises:

Along the expandable part that prolonging direction extends, described expandable part limits a plurality of rings, and described a plurality of rings limit corresponding opening, and wherein said corresponding opening is in alignment with each other basically along described prolonging direction;

Eyelet from described expandable part extension; And

The actuation member that comprises first section and second section, described first section and second section extend through described eyelet and pass described expandable part,

Wherein said actuation member is configured to receive actuation force, and in response to described actuation force described expandable part is actuated to expanded configuration from first configuration, wherein under first configuration, described expandable part limits first maximum ga(u)ge along second direction, described second direction is offset from described prolonging direction angledly, wherein under expanded configuration, described expandable part is along second maximum ga(u)ge of described second direction restriction greater than described first maximum ga(u)ge.

115. according to the described inflatable grappling part of claim 114, wherein when described expandable part was actuated to described expanded configuration from described first configuration, described eyelet extended through described expandable part.

116. according to the described inflatable grappling part of claim 115, wherein said expandable part limits near-end, relative far-end and is arranged on the distally ring of described far-end, described eyelet is from described remote extension, and limits the make position against described far-end when described eyelet is pulled through described expandable part.

117. according to the described inflatable grappling part of claim 114, wherein when described expandable part was actuated to described expanded configuration from described first configuration, described ring was against piling up each other.

118. according to the described inflatable grappling part of claim 114, wherein each ring limits at least one pair of knot.

119. according to the described inflatable grappling part of claim 118, wherein each in the described a pair of knot of each ring is set to relative basically with another person.

120. according to the described inflatable grappling part of claim 119, wherein each in the described a pair of knot of each ring is set to become 180 degree basically with another person.

121. according to the described inflatable grappling part of claim 118, wherein a plurality of at least described knots are configured to reef knot.

122. according to the described inflatable grappling part of claim 118, wherein a plurality of at least described knots are configured to the anticreep knot.

123. according to the described inflatable grappling part of claim 114, wherein when described expandable part is in described first configuration, described eyelet extends into described expandable part first length at least, and when described expandable part is in described expanded configuration, described eyelet extends into described expandable part second length at least, and wherein said second length is greater than described first length.

124. according to the described inflatable grappling part of claim 114, also comprise a pair of eyelet that extends from described expandable part.

125. according to the described inflatable grappling part of claim 124, wherein said actuating strand passes both in the described a pair of eyelet.

Images